STEPHANIE A. GRANVALL (NPI# 1861477960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861477960 |
| Entity Type | Individual |
| Full Name | STEPHANIE A. GRANVALL |
| Credential | P.A.-C |
| Practice Address |
751 Ne Blakely Dr Suite 4020 Issaquah WA 98029-6201 |
| Mailing Address |
Po Box 25608 Salt Lake City UT 84125-0608 |
| Practice Telephone | 4253137124 |
| Practice Fax Number | 4253137057 |
| Mailing Telephone | 2063204476 |
| Mailing Fax Number | 2065687043 |
| Enumeration Date | 2005-12-12 |
| Last Update Date | 2013-05-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA60321925 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
751 NE BLAKELY DR SUITE 4020 |
| City | ISSAQUAH |
| State | WA |
| Zip Code | 98029-6201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154325751 | Ann-elizabeth Georgianne Jarris | Emergency Medicine | 751 Ne Blakely Dr, Issaquah, WA 98029-6201 | 2005-06-10 |
| 1952935157 | Sunny Yoon | Registered Nurse | 751 Ne Blakely Dr, Swedish Issaquah Campus, Issaquah, WA 98029-6201 | 2020-02-26 |
| 1760012868 | Pacmed Clinics | Clinic/Center | 751 Ne Blakely Dr, Issaquah, WA 98029-6201 | 2020-01-17 |
| 1851864193 | Rachel Licia Crawford | Registered Nurse | 751 Ne Blakely Dr, Issaquah, WA 98029-6201 | 2019-01-09 |
| 1538617881 | Jan Marie Kay | Pharmacist | 751 Ne Blakely Dr, Testing and Treatment 3rd Floor, Issaquah, WA 98029-6201 | 2016-09-15 |
| 1639627177 | Veronica Esquibel | Pharmacist | 751 Ne Blakely Dr, Issaquah, WA 98029-6201 | 2016-09-13 |
| 1326406968 | Heather Hires | Registered Nurse | 751 Ne Blakely Dr, Issaquah, WA 98029-6201 | 2016-02-09 |
| 1841664729 | Yeachan Hwang | Student in an Organized Health Care Education/Training Program | 751 Ne Blakely Dr, Issaquah, WA 98029-6201 | 2015-11-16 |
| 1588036909 | Carrie Hall | Registered Nurse | 751 Ne Blakely Dr, Issaquah, WA 98029-6201 | 2015-10-25 |
| 1376914721 | Jessica D Kim | Dietitian, Registered | 751 Ne Blakely Dr, 3rd Floor, Issaquah, WA 98029-6201 | 2015-10-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134730161 | Katelyn Creech | Counselor | 1505 16th Lane Ne, Apt 404 Building O, Issaquah, WA 98029 | 2020-08-13 |
| 1326695438 | M Shoaib Haider Siddiqui | Dentist | Issaquah Modern Dentistry, 1416 Highlands Drie Ne, Suite 120, Issaquah, WA 98029 | 2019-08-22 |
| 1053885061 | Rose Osborne | Registered Nurse | 4580 Klahanie Dr Se #181, Sammamish, WA 98029 | 2019-01-14 |
| 1598260960 | Caryn Crosbie | Behavior Technician | 22526 Se 64th Place, Building D Suite 210, Issaquah, WA 98029 | 2018-03-28 |
| 1194110908 | May Y. Mar | Family Medicine | 5708 E. Lake Sammamish Pkwy Se, Issaquah, WA 98029 | 2015-03-30 |
| 1659765816 | Eastside Social Skills Therapy LLC | Preferred Provider Organization | 5436 232nd Ave Se, Issaquah, WA 98029 | 2015-03-26 |
| 1649513946 | Linda Scoppettone Knodel | Registered Nurse | 5303 231 Ave. Se, Issaquah, WA 98029 | 2013-04-04 |
| 1720323116 | Morley Slutsky | Preventive Medicine | 4580 Klahanie Dr. S.e.,#125, Issaquah, WA 98029 | 2012-12-11 |
| 1619248820 | Silas Dickenson Dudley | Dentist | 2520 Ne Park Dr, Suite C, Issaquah, WA 98029 | 2012-01-19 |
| 1659641678 | Cynthia J Creel | Technician/Technologist | 4580 Klahanie Dr. Se, #332, Issaquah, WA 98029 | 2012-01-06 |
| Find all providers in zip 98029 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114575966 | Josiah Odhiambo Owinyo | Physician Assistant | 751 Ne Blakely Dr Ste 4020, Issaquah, WA 98029-6201 | 2019-08-26 |
| 1235674664 | Jennifer Lynn Krick | Physician Assistant | 510 8th Ave Ne, Suite 200, Issaquah, WA 98029-5436 | 2016-12-20 |
| 1699222778 | Anna Marie Must | Physician Assistant | 751 Ne Blakely Dr Ste 4020, Issaquah, WA 98029-6201 | 2016-09-06 |
| 1417291600 | Briccio J Guillermo | Physician Assistant | 751 Ne Blakely Dr Ste 4020, Issaquah, WA 98029-6201 | 2012-11-12 |
| 1871890376 | Kelli Michelle Patterson-lawlor | Physician Assistant | 751 Ne Blakely Dr, Suite #4020, Issaquah, WA 98029-6201 | 2011-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780153536 | Patricia Dorian | Physician Assistant | 2950 Squalicum Pkwy Ste B, Bellingham, WA 98225-1857 | 2018-11-21 |
| 1851875561 | Sarah Gene Soloff | Physician Assistant | 9730 3rd Ave Ne Ste 201, Seattle, WA 98115-2023 | 2018-09-18 |
| 1104308394 | Johnny Thanh Nguyen | Physician Assistant | 1135 116th Ave Ne Ste 605, Bellevue, WA 98004-4697 | 2018-09-04 |
| 1558843201 | Stefanie Eller | Physician Assistant | 532 Cedar Wood Ln, Wenatchee, WA 98801-2476 | 2018-08-29 |
| 1861987992 | Lillian Baldwin Bourret | Physician Assistant | 6317 Linden Ave N, Seattle, WA 98103-5658 | 2018-07-01 |
| 1417446758 | Janelle Elizabeth Becker | Physician Assistant | 11511 Canterwood Blvd Nw Ste 205, Gig Harbor, WA 98332 | 2018-05-02 |
| 1982058418 | Ray Johnson | Physician Assistant | 4446 88th Ave Se, Mercer Island, WA 98040 | 2016-04-21 |
| 1073990651 | Laura Skanse | Physician Assistant | 12303 Ne 130th Ln #500, Kirkland, WA 98034 | 2015-05-02 |
| 1104231893 | Amber Elaine Deck | Physician Assistant | 20307 67th Ave E, Spanaway, WA 98387-5600 | 2014-06-22 |
| 1043535024 | Pamela Baird | Physician Assistant | 2016 16th Ave East, Seattle, WA 98112-5260 | 2010-04-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.