Provider Demographics
NPI:1174667752
Name:ADAMS, STEFANIE LEIGH (LMT)
Entity type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:LEIGH
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15103 NE 356TH ST
Mailing Address - Street 2:
Mailing Address - City:YACOLT
Mailing Address - State:WA
Mailing Address - Zip Code:98675-4005
Mailing Address - Country:US
Mailing Address - Phone:360-798-0346
Mailing Address - Fax:564-221-4922
Practice Address - Street 1:408 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-8506
Practice Address - Country:US
Practice Address - Phone:360-993-0273
Practice Address - Fax:360-694-9662
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00012278225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist