Active NPI
Deanna Marie Stoltenberg, PHARMD
- Pharmacist
- Puyallup, WA
National Provider Identifier
1295871911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00022577
- Practice address
- 16205 131St Avenue CT E
Puyallup, WA 98374-9248 - Phone
- (253) 841-5975
- NPI assigned
- Jan 29, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH00022577 | WA | Primary |
Addresses
Primary practice location
16205 131St Avenue CT E
Puyallup, WA 98374-9248
Mailing address
16205 131St Avenue CT E
Puyallup, WA 98374-9248
Phone (253) 841-5975
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PH00022577 | Other | WA | STATE LICENSE |
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH00022577 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295871911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16205 131ST AVENUE CT E",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983749248",
"telephone_number": "253-841-5975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16205 131ST AVENUE CT E",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983749248",
"telephone_number": "253-841-5975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLTENBERG",
"first_name": "DEANNA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00022577",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "PH00022577",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.