Gregory Douglas Stewart Sr., PA, RN, CNOR, CRNFA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA10002153 Issued in WA

Practice address

2424 122ND St SW
B
Everett, WA 98204-4744

Phone

(206) 948-4671

Fax

(425) 513-9456

NPI assigned

Oct 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gregory D. Stewart

  • Surgical Physician Assistant
  • Seattle, WA
  • NPI 1376042879
  NPD (past) Authorized official

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1295822740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1542",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982757742",
            "telephone_number": "206-948-4671",
            "fax_number": "425-513-9456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 122ND ST SW",
            "address_2": "B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982044744",
            "telephone_number": "206-948-4671",
            "fax_number": "425-513-9456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "GREGORY",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "PA, RN, CNOR, CRNFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA10002153",
            "primary": true
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "WA",
            "license": "25800059197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lacee Stevenson
• Kristy Stevlingson, PA-C
• Anna Stewart
• Elizabeth Karen Stewart, DO
• Erin Stewart
• Harold V. Stewart, M.D.
• Jennifer Krista Stewart, PTA
• Natalie Jean Stewart, LMHCA
• Scott Stewart, BA, CP
• Shelley Maree Stewart, SUDP

• Surgical Physician Assistant in Everett, WA
• Providers in Everett, WA by specialty
• Surgical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.