STACEY L. HILES, M.D., PLLC (NPI# 1093963795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093963795 |
| Entity Type | Organization |
| Organization Name | STACEY L. HILES, M.D., PLLC |
| Practice Address |
17900 Talbot Rd S Suite 101 Renton WA 98055-8212 |
| Practice Telephone | 4252359614 |
| Practice Fax Number | 4252351060 |
| Mailing Telephone | 4252359614 |
| Mailing Fax Number | 4252351060 |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2008-12-27 |
| Authorized Official Name | DR. STACEY L. HILES (FAMILY PRACTICE PHYSICIAN) |
| Authorized Official Telephone | 4252359614 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
60021347 | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1126143 | 05 |
| Street Address |
17900 TALBOT RD S SUITE 101 |
| City | RENTON |
| State | WA |
| Zip Code | 98055-8212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255365839 | Daniel Leahy Graves | Legal Medicine | 17900 Talbot Rd S, #101, Renton, WA 98055-8212 | 2006-07-10 |
| 1518340686 | Luke St. Marie | Dentist | 17900 Talbot Rd S, Ste #103, Renton, WA 98055-8212 | 2015-07-07 |
| 1205164639 | Maranatha Medical Clinic Inc P S | Internal Medicine | 17900 Talbot Rd S, #101, Renton, WA 98055-8212 | 2009-11-23 |
| 1063748861 | Maranatha Medical Clinic Inc P S | Clinic/Center | 17900 Talbot Rd S, #101, Renton, WA 98055-8212 | 2009-10-29 |
| 1871724658 | Marianne Stewart Johnston | Physician Assistant | 17900 Talbot Rd S, Suite 101, Renton, WA 98055-8212 | 2009-07-28 |
| 1487892659 | Donald Dale Hubbard | Orthopaedic Surgery | 17900 Talbot Rd S, Suite 101, Renton, WA 98055-8212 | 2009-01-27 |
| 1558506097 | Leigh Christine Kenner | Dentist | 17900 Talbot Rd S, Suite 103, Renton, WA 98055-8212 | 2008-12-12 |
| 1922266162 | Stacey Lee Hiles | Family Medicine | 17900 Talbot Rd S, Ste 101, Renton, WA 98055-8212 | 2008-05-23 |
| 1295889962 | William Ronald Wilkinson | Psychologist | 17900 Talbot Rd S, Suite 102, Renton, WA 98055-8212 | 2007-01-22 |
| 1801903323 | Gary H Kato | Family Medicine | 17900 Talbot Rd S, #102, Renton, WA 98055-8212 | 2006-08-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965750 | Proliance Surgery Center At Valley, LLC | Clinic/Center | 4009 Talbot Road S, Suite 200, Renton, WA 98055 | 2020-06-01 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1154878668 | Nelson Family Dentistry | Dentist | 19221 108th Ave Se Suite #2, Renton, WA 98055 | 2016-09-01 |
| 1598182990 | Annie Kyunga Ahn | Otolaryngology | 4033 Talbot Rd S Ste 540, Renton, WA 98055 | 2014-03-24 |
| 1376960138 | Madhuri Gordhan Patel | Registered Nurse | 3501 Mill Place South, Renton, WA 98055 | 2014-03-18 |
| 1912331042 | Karen Dohr | Pharmacist | 400 S. 43 Street, Renton, WA 98055 | 2013-08-26 |
| 1659637668 | Benjamin Reiss | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055 | 2012-04-03 |
| 1205137940 | Duy Ai Quang Hoang | Pharmacist | 9431 S 196th Pl, Renton, WA 98055 | 2010-11-11 |
| 1972823664 | Erica L Ellzey | Physical Therapist | 18623 112th Ave Se, Renton, WA 98055 | 2010-06-04 |
| 1588984587 | Melissa A. Jordan | Nurse Anesthetist, Certified Registered | 4011 Talbot Rd., 5th Floor, Renton, WA 98055 | 2010-06-02 |
| Find all providers in zip 98055 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568746345 | Concerto Medical Group of Washington, P.C. | Clinic/Center | 1412 Sw 43rd Street, Ste 315, Renton, WA 98057 | 2011-09-28 |
| 1356541882 | Children First Pediatrics, Pllc | Clinic/Center | 4361 Talbot Rd S, Suite 103, Renton, WA 98055-6226 | 2007-07-23 |
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|---|---|---|---|---|
| 1992315808 | Vera Whole Health Wa, PC | Clinic/Center | 6700 Fort Dent Way Ste 100, Tukwila, WA 98188-2500 | 2020-08-05 |
| 1063037034 | Pioneer Family Medicine, Pllc | Clinic/Center | 20 E J St Ste 2b, Deer Park, WA 99006-8500 | 2020-06-15 |
| 1922622158 | Vera Whole Health Wa, PC | Clinic/Center | 16009 E Indiana Ave, Spokane Valley, WA 99216 | 2020-06-03 |
| 1578183729 | Family Care Network Pllc | Clinic/Center | 3548 Meridian St, Suite #101-b, Bellingham, WA 98225 | 2020-04-17 |
| 1548800451 | Vera Whole Health Wa PC | Clinic/Center | 1601 N Division St, Spokane, WA 99207-2427 | 2020-01-08 |
| 1821634312 | Columbia Basin Mobile Medicine LLC | Clinic/Center | 1357 Platinum Pl, West Richland, WA 99353-5108 | 2019-11-20 |
| 1063056497 | A Community Wellness Clinic LLC | Clinic/Center | 2405 E 17th Ave Ste 113, Spokane, WA 99223-5122 | 2019-10-29 |
| 1013550987 | Rejuventa Medical Corp. | Clinic/Center | 107 North Tower Ave Suite 17, Centralia, WA 98531-4253 | 2019-10-23 |
| 1023668407 | Vera Whole Health Wa, PC | Clinic/Center | 4933 Evergreen Way, Everett, WA 98203-2828 | 2019-09-17 |
| 1679042501 | Family and Wellness Medicine | Clinic/Center | 34004 16th Ave S Ste 100, Federal Way, WA 98003-8905 | 2018-11-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.