Individual
THOMAS LOGAN STACKHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2940 SQUALICUM PKWY, STE 203, BELLINGHAM, WA 98225-1892
(360) 733-0640
(360) 733-1034
Mailing address
2940 SQUALICUM PKWY, STE 203, BELLINGHAM, WA 98225-1892
(360) 733-0640
(360) 733-1034
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
MD00029527
WA
207Y00000X
Otolaryngology Physician
Primary
MD00029527
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8137978
—
WA
Enumeration date
08/24/2005
Last updated
04/05/2021
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