Individual provider Active NPI

Stephanie Elizabeth Anne Dalton, LMP

  • Community Health Worker
  • Coupeville, WA
National Provider Identifier
1275793986
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
MA00022996 Issued in WA
Practice address
308 S Main St
Coupeville, WA 98239
Phone
(360) 678-4417
NPI assigned
Jun 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X MA00022996 WA Primary

Addresses

Primary practice location

308 S Main St
Coupeville, WA 98239

Mailing address

PO Box 1885
Oak Harbor, WA 98277-1885
Phone (360) 720-8455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA00022996WAMDCommunity Health Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1275793986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1885",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982771885",
            "telephone_number": "360-720-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 S MAIN ST",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "98239",
            "telephone_number": "360-678-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALTON",
        "first_name": "STEPHANIE",
        "middle_name": "ELIZABETH ANNE",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "WA",
            "license": "MA00022996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coupeville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.