Doctor Name: | JESSI MICHELLE STOCCO |
NPI Number: | 1447457007 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMP |
License Number: | MA00016500 |
Business Practice Address: | 15220 Se 272nd St Suite G Kent, WA - 980424241 |
Business Phone Number: | 2536306768 |
Business Fax Number: | 2536306639 |
Mailing Address: | 31600 126th Ave Se, #76 AUBURN |
State: | WA |
Postal Code: | 980920914 |
Phone Number: | 2069488058 |
Fax Number: | |
NPI Enumeration Date: | 06/28/2007 |
NPI Last Update Date: | 08/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA00016500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |