Individual
GRANT STOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1295 FOWLER ST STE 102, RICHLAND, WA 99352-4736
(509) 783-2004
Mailing address
4810 BIRCH RD, PASCO, WA 99301-9046
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
WA
Other
Enumeration date
07/20/2024
Last updated
11/04/2025
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