Stafford, Olympia
Stafford, Olympia is an individual health care provider with primary practice located at 1628 S Mildred St Ste 104 , Tacoma WA 98465-1628. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Stafford, Olympia can be contacted via phone (253) 301-5640.Contact Information
Primary practice address
1628 S Mildred St Ste 104
Tacoma WA 98465-1628
Phone: (253) 301-5640
Fax: (253) 301-5645
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD00041509 | Washington |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | MD00041509 | Washington |
Profile Details
| NPI number | 1740382670 |
|---|---|
| LBN Legal business name | Stafford, Olympia |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 1st, 2006 |
| Last updated | Mar 16th, 2026 - about 8 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740382670 | NPPES |
| Washington | MEDICAID | 1017959 |
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