Doctor Name: | MARCUS A STOLL |
NPI Number: | 1144414178 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMP |
License Number: | MA00023934 |
Business Practice Address: | 105 W Main Suite A Puyallup, WA - 98375 |
Business Phone Number: | 2533073913 |
Business Fax Number: | 2536044450 |
Mailing Address: | 105 W Main, Suite A PUYALLUP |
State: | WA |
Postal Code: | 98375 |
Phone Number: | 2533073913 |
Fax Number: | 2536044450 |
NPI Enumeration Date: | 09/03/2007 |
NPI Last Update Date: | 01/07/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA00023934 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |