Individual
DR. THOMAS BODLEY STIBOLT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3500 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(503) 652-2880
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2031
(503) 652-2880
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
MD00035026
WA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD14564
OR
207RP1001X
Pulmonary Disease Physician
MD00035026
WA
207RP1001X
Pulmonary Disease Physician
MD14564
OR
Other
Enumeration date
08/18/2006
Last updated
09/11/2025
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