Individual provider Active NPI

Debra Stolle

  • Computed Tomography Radiologic Technologist
  • Moses Lake, WA
National Provider Identifier
1245786136
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Computed Tomography Radiologic TechnologistTaxonomy code 2471C3401X
License
233933 Issued in WA
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

Updated by the provider on Aug 30, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
233933WAMDComputed 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.

Verify at the official NPI Registry.