Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
STACEY JONELLE VAN TASSEL, L.M.P.
Active Sole ProprietorSTACEY JONELLE VAN TASSEL, L.M.P. is a Specialist healthcare provider located in BLACK DIAMOND, Washington. NPI 1124214267 is currently active in the NPPES registry. Verify at CMS.
Specialist · BLACK DIAMOND, WA
Registration Details
- NPI Number
- 1124214267
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 21, 2007 (18.715824479358 yrs)
- Last Updated
- Sep 21, 2007
- License
-
MA00020492 (WA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
29034 216TH AVE SEBLACK DIAMOND, WA, 980101297Browse WA providers · Browse ZIP 98010
- Phone
- 3608862649
- Primary Specialty
-
Specialist
174400000X
Other Specialist Providers in BLACK DIAMOND, WA
| Name | Credential | NPI |
|---|---|---|
| KRISTINE SCOTT | LMP | 1508002858 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.