Holly June Stafford, DNP, ARNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP60755721 Issued in WA

Practice address

1700 NW Gilman Blvd Ste 205
Issaquah, WA 98027-5364

Phone

(562) 587-3577

NPI assigned

May 18, 2017

Last updated

May 18, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495065600000",
    "number": "1457888695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 FRONT ST N",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272914",
            "telephone_number": "562-587-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 NW GILMAN BLVD STE 205",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275364",
            "telephone_number": "562-587-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "HOLLY",
        "middle_name": "JUNE",
        "credential": "DNP, ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-18",
        "last_updated": "2017-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP60755721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James F Spiegel, M.D.
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• Catherine Springman, LMT
• Squak Mountain Physical Therapy, Inc.
• Sarah Christine Squires, COTA/L
• Sarah Loughran Stanos, D.O.
• Jessica Stark, PSYD
• Cheryl A C Steele, MA, LMHCA
• Trista Steele
• Amanda S Stefanin, LMP

• Pediatric Nurse Practitioner in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Pediatric Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2017; 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.