Individual provider Active NPI

Stephanie Wear, LMP

  • Specialist
  • Lynden, WA
National Provider Identifier
1477957884
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA60450749 Issued in WA
Practice address
8862 Bender Rd
Suit 101
Lynden, WA 98264-8800
Phone
(360) 354-1115
Fax
(360) 354-0321
NPI assigned
Oct 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA60450749 WA Primary

Addresses

Primary practice location

8862 Bender Rd
Suit 101
Lynden, WA 98264-8800

Mailing address

8862 Bender Rd
Suit 101
Lynden, WA 98264-8800
Phone (360) 354-1115

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
MA60450749WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1477957884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8862 BENDER RD",
            "address_2": "SUIT 101",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982648800",
            "telephone_number": "360-354-1115",
            "fax_number": "360-354-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8862 BENDER RD",
            "address_2": "SUIT 101",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982648800",
            "telephone_number": "360-354-1115",
            "fax_number": "360-354-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAR",
        "first_name": "STEPHANIE",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-14",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA60450749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynden, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; 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.