Provider Demographics
NPI:1073584314
Name:STONE, LEE JAYSON (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:JAYSON
Last Name:STONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W 8TH AVE
Mailing Address - Street 2:SUITE 6010
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2341
Mailing Address - Country:US
Mailing Address - Phone:509-838-5950
Mailing Address - Fax:509-838-5961
Practice Address - Street 1:105 W 8TH AVE
Practice Address - Street 2:SUITE 6010
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2341
Practice Address - Country:US
Practice Address - Phone:509-838-5950
Practice Address - Fax:509-838-5961
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD23397207RG0100X
WAMD60187917207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR287261Medicaid
ORG72350Medicare UPIN
OR121427Medicare ID - Type Unspecified