Diane R Staves, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00038077 Issued in WA

Practice address

2510 Sulwhanon Dr
Everson, WA 98247-9749

Phone

(360) 966-2106

Fax

(360) 966-2304

NPI assigned

Jan 9, 2007

Last updated

Apr 29, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nooksack Central Management System

  • Family Medicine Physician
  • Everson, WA
  • NPI 1568528842
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367193600000",
    "number": "1669521704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 157",
            "city": "DEMING",
            "state": "WA",
            "postal_code": "982440157",
            "telephone_number": "360-733-4229",
            "fax_number": "360-733-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 SULWHANON DR",
            "city": "EVERSON",
            "state": "WA",
            "postal_code": "982479749",
            "telephone_number": "360-966-2106",
            "fax_number": "360-966-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVES",
        "first_name": "DIANE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2013-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00038077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8268518",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1669521704",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sea-Mar Community Health Center
• Sara L. Sheaffer, D.O.
• Mary Ellen Shields, M.D.
• Deanna Sloane, CCC-SLP
• Erica Christine Smith, LMHCA
• Sandra L Stork, RC
• Paula Renae Stratman
• Shaye Swannack
• Tracie Tamashiro
• Kendall Tetsworth

• Internal Medicine Physician in Everson, WA
• Providers in Everson, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.