Provider Demographics
NPI:1861213506
Name:GREGG, STEPHANI JIHAN
Entity type:Individual
Prefix:
First Name:STEPHANI
Middle Name:JIHAN
Last Name:GREGG
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 1:7310 66TH AVE W
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-8329
Mailing Address - Country:US
Mailing Address - Phone:253-266-2303
Mailing Address - Fax:
Practice Address - Street 1:7310 66TH AVE W
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-8329
Practice Address - Country:US
Practice Address - Phone:253-266-2303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula