Individual
ERIC R STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
FAMILY MEDICINE, 835 EAST FAIRHAVEN AVENUE, BURLINGTON, WA 98233-0329
(360) 856-7960
(360) 755-1405
Mailing address
1115 SE 164TH AVE DEPT 358, VANCOUVER, WA 98683-8004
(360) 729-1462
(360) 729-3104
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00033859
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8206153
—
WA
Enumeration date
03/14/2006
Last updated
07/22/2019
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