Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD60212084 | WA |
N | 111NI0900X | Internist | MD60212084 | WA |
NPI | 1003076332 |
---|---|
Provider Name | Stephen A Lopez |
First Address | Seattle, WA 98101-2756 |
Second Address | Seattle, WA 98101-2742 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2008 |
Last Update Date | 05/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003076332 | (05) | WA |
1003076332 | IDAHO MEDICAID (01) | WA |
P01038749 | RAILROAD MEDICARE (01) | WA |