Individual
STEPHEN LAURENCE BOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1717 S J ST, TACOMA, WA 98405-4933
(844) 364-2778
(253) 383-0161
Mailing address
1717 S J ST, TACOMA, WA 98405-4933
(844) 364-2778
(253) 383-0161
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101045085
VA
207L00000X
Anesthesiology Physician
Primary
MD60833931
WA
207LP2900X
Pain Medicine (Anesthesiology) Physician
0101045085
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2104430
—
WA
Enumeration date
01/19/2006
Last updated
12/01/2020
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