Active NPI
Marcus A Stoll, LMP
- Specialist
- Puyallup, WA
National Provider Identifier
1144414178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00023934
- Practice address
- 105 W Main
Suite a
Puyallup, WA 98375 - Phone
- (253) 307-3913
- Fax
- (253) 604-4450
- NPI assigned
- Sep 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA00023934 | WA | Primary |
Addresses
Primary practice location
105 W Main
Suite a
Puyallup, WA 98375
Mailing address
105 W Main
Suite a
Puyallup, WA 98375
Phone (253) 307-3913
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00023934 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231286400000",
"number": "1144414178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 W MAIN",
"address_2": "SUITE A",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "98375",
"telephone_number": "253-307-3913",
"fax_number": "253-604-4450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 W MAIN",
"address_2": "SUITE A",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "98375",
"telephone_number": "253-307-3913",
"fax_number": "253-604-4450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLL",
"first_name": "MARCUS",
"middle_name": "A",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-03",
"last_updated": "2009-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA00023934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.