Healthcare Provider Details
I. General information
NPI: 1538269006
Provider Name (Legal Business Name): ADDISON T STONE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/25/2006
Last Update Date: 12/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
901 BOREN AVE SUITE 800
SEATTLE WA
98104-3534
US
IV. Provider business mailing address
805 MADISON ST SUITE 901
SEATTLE WA
98104-1172
US
V. Phone/Fax
- Phone: 206-323-1900
- Fax: 206-323-6868
- Phone: 206-264-8100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | ML20008136 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | MD60137857 |
| License Number State | WA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0117X |
| Taxonomy | Orthopaedic Surgery of the Spine Physician |
| License Number | MD60137857 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: