Individual provider Active NPI

Stephen Joseph Shlafer, MD

  • Pediatrics Physician
  • Mill Creek, WA
National Provider Identifier
1629185111
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00028401 Issued in WA
Practice address
15808 Mill Creek Blvd
Suite 201
Mill Creek, WA 98012-1500
Phone
(425) 338-5668
Fax
(425) 338-4366
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00028401 WA Primary

Addresses

Primary practice location

15808 Mill Creek Blvd
Suite 201
Mill Creek, WA 98012-1500

Mailing address

15808 Mill Creek Blvd
Suite 201
Mill Creek, WA 98012-1500
Phone (425) 338-5668

Other identifiers 1

IdentifierTypeStateIssuer
1106749MedicaidWA

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 Medicine

State licenses

LicenseStateTypeSpecialty
MD00028401WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Sound Pediatrics Pediatrics PastSince Jul 28, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1629185111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15808 MILL CREEK BLVD",
            "address_2": "SUITE 201",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121500",
            "telephone_number": "425-338-5668",
            "fax_number": "425-338-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15808 MILL CREEK BLVD",
            "address_2": "SUITE 201",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121500",
            "telephone_number": "425-338-5668",
            "fax_number": "425-338-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHLAFER",
        "first_name": "STEPHEN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00028401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1106749",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.