Provider Demographics
NPI:1225471030
Name:STOLZ, THOMAS HUSTON (CDP)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:HUSTON
Last Name:STOLZ
Suffix:
Gender:M
Credentials:CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 N WASHINGTON ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2202
Mailing Address - Country:US
Mailing Address - Phone:509-327-9831
Mailing Address - Fax:509-327-9857
Practice Address - Street 1:910 N WASHINGTON ST
Practice Address - Street 2:SUITE 210
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2202
Practice Address - Country:US
Practice Address - Phone:509-327-9831
Practice Address - Fax:509-327-9857
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00004658101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)