Provider Demographics
NPI:1073552394
Name:STONE, ALLISTER GORDON CHRISTIAN (DO)
Entity Type:Individual
Prefix:
First Name:ALLISTER
Middle Name:GORDON CHRISTIAN
Last Name:STONE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 S 336TH ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6328
Mailing Address - Country:US
Mailing Address - Phone:253-836-6180
Mailing Address - Fax:253-838-6418
Practice Address - Street 1:1717 S J ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4933
Practice Address - Country:US
Practice Address - Phone:253-426-6660
Practice Address - Fax:360-738-6377
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58-001352207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5512STOtherBSWA
WA0221350OtherLIWA
WA8483653Medicaid
WA0221349OtherLIWA
WA6277STOtherBSWA
WAG8866029Medicare PIN
WAI62574Medicare UPIN
WAP00411768Medicare PIN