Provider Demographics
NPI:1164276549
Name:STEPCHUK, TATYANA (ARNP)
Entity type:Individual
Prefix:
First Name:TATYANA
Middle Name:
Last Name:STEPCHUK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:
Other - Last Name:STEPCHUK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:36812 55TH AVE S
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-8812
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:604 OAKESDALE AVE SW
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5204
Practice Address - Country:US
Practice Address - Phone:253-335-8003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61579499363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner