Provider Demographics
NPI:1851476709
Name:STONNELL, DAVID K (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:K
Last Name:STONNELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4540 CORDATA PKWY 103
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-4911
Mailing Address - Country:US
Mailing Address - Phone:360-676-8663
Mailing Address - Fax:360-676-8682
Practice Address - Street 1:4540 CORDATA PKWY 103
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8059
Practice Address - Country:US
Practice Address - Phone:360-676-8663
Practice Address - Fax:360-676-8682
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00001938152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8850167Medicare PIN
U12354Medicare UPIN