Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DE60606151 | WA |
NPI | 1134478795 |
---|---|
Provider Name | Tristan J Stone |
First Address | Bellingham, WA 98229-2318 |
Second Address | Bellingham, WA 98229-6264 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2012 |
Last Update Date | 21/12/2021 |