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General NPI Number Information
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NPI Number | 1699736637
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Entity Type | Individual
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Provider Name | HERBERT EDWIN STICKLE MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 2000 HOSPITAL DR
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City | SEDRO WOOLLEY
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State | WA
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Zip | 98284-4327
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Country | US
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Telephone | 360-856-6021
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Fax |
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Provider Business Mailing Address
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Address Line | 1776 WOODSTEAD CT STE 208
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City | THE WOODLANDS
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State | TX
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Zip | 77380-1480
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Country | US
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Telephone | 877-749-7428
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00034310
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD00034310
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207LH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Anesthesiology) Physician
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License Number | MD00034310
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License Number State | WA
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