Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stephanie Lynne Shah

Individual provider Physician Assistant · NPI 1639666118

Stephanie Lynne Shah is a Physician Assistant in Tacoma, Washington. Qualified in 2018, 8 years ago. Practices with Prudy Medical, a 5-clinician group and accepts Medicare assignment.

Years since qualifying
8
In the registry since
2018
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Practice location Address checks out

209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Phone: (253) 596-3300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1639666118
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 19, 2018
Last updated in NPPESMay 5, 2021
Certification dateMay 5, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Prudy Medical — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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