Provider Demographics
NPI:1629812532
Name:STOKKE, DARRIAN
Entity type:Individual
Prefix:
First Name:DARRIAN
Middle Name:
Last Name:STOKKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 128TH ST SW APT F203
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-5369
Mailing Address - Country:US
Mailing Address - Phone:425-408-3122
Mailing Address - Fax:
Practice Address - Street 1:902 PINE ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-1403
Practice Address - Country:US
Practice Address - Phone:425-610-2075
Practice Address - Fax:833-485-0438
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist