Individual
ALISON STULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
505 NE 87TH AVE STE 301, VANCOUVER, WA 98664-1965
(360) 514-7374
(360) 514-7384
Mailing address
847 NE 19TH AVE, SUITE 300, PORTLAND, OR 97232-2684
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61131763
WA
363AS0400X
Surgical Physician Assistant
PA.200731
LA
363AS0400X
Surgical Physician Assistant
PA170090
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2040038
—
WA
05
—
500677537
—
OR
Enumeration date
09/25/2014
Last updated
12/04/2024
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