Active NPI
Debra Stolle
- Computed Tomography Radiologic Technologist
- Moses Lake, WA
National Provider Identifier
1245786136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Computed Tomography Radiologic Technologist
- License
- 233933
- Practice address
- 1008 S Garden Dr
Moses Lake, WA 98837-2330 - Phone
- (509) 765-2587
- NPI assigned
- Aug 30, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Computed Tomography Radiologic Technologist | 2471C3401X | 233933 | WA | Primary |
Addresses
Primary practice location
1008 S Garden Dr
Moses Lake, WA 98837-2330
Mailing address
1008 S Garden Dr
Moses Lake, WA 98837-2330
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 |
|---|---|---|---|
| 233933 | WA | MD | Computed Tomography Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472515200000",
"number": "1245786136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 S GARDEN DR",
"city": "MOSES LAKE",
"state": "WA",
"postal_code": "988372330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1008 S GARDEN DR",
"city": "MOSES LAKE",
"state": "WA",
"postal_code": "988372330",
"telephone_number": "509-765-2587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLLE",
"first_name": "DEBRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-30",
"last_updated": "2016-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "2471C3401X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Computed Tomography",
"state": "WA",
"license": "233933",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Moses Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.