GARY STACK (NPI# 1487694535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487694535 |
| Entity Type | Individual |
| Full Name | GARY STACK |
| Credential | MD |
| Practice Address |
4310 Colby Ave Suite 203 Everett WA 98203-2338 |
| Practice Telephone | 4252528102 |
| Mailing Telephone | 4252528102 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2008-01-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | MD00012487 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | STATE LICENSE NUMBER | MD00012487 | 01 |
| WA | LABOR AND INDUSTRY | 0050032 | 01 |
| WA | 1067305 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982687463 | Gary E Stack | Pathology | 800 Howard Ave, Yale Physicians Building, New Haven, CT 06519-1369 | 2005-11-29 |
| Street Address |
4310 COLBY AVE SUITE 203 |
| City | EVERETT |
| State | WA |
| Zip Code | 98203-2338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912954744 | Terry Spark Corwin | Urology | 4310 Colby Ave, Suite 203, Everett, WA 98203-2338 | 2006-05-27 |
| 1710396387 | Rebecca Epperson | Nurse Practitioner | 4310 Colby Ave, Everett, WA 98203-2338 | 2014-08-08 |
| 1174845804 | Anne Eileen Niggemeyer | Psychologist | 4310 Colby Ave, Suite201, Everett, WA 98203-2338 | 2010-02-22 |
| 1285852681 | Western Washington Medical Group, Inc Ps | Otolaryngology | 4310 Colby Ave, Suite 203, Everett, WA 98203-2338 | 2007-04-23 |
| 1457416471 | Willow I Radford | Massage Therapist | 4310 Colby Ave, 202, Everett, WA 98203-2338 | 2006-12-27 |
| 1063428464 | Kristin K Schaaf | Psychologist | 4310 Colby Ave, Suite 201, Everett, WA 98203-2338 | 2006-07-31 |
| 1407888910 | Brian Chi-ming Fong | Urology | 4310 Colby Ave, Suite 203, Everett, WA 98203-2338 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083226039 | Lisa Mcgregor | Counselor | Sea Mar Community Health Centers, 5007 Claremont Way, Everett, WA 98203 | 2020-08-20 |
| 1417572009 | Megan Ostermick-durkee | Student in an Organized Health Care Education/Training Program | Sunrise Services Inc., 811 Madison Street, Everett, WA 98203 | 2020-06-10 |
| 1134741424 | Tara Lin Garcia | Peer Specialist | 4256 Federal Avenue, Everett, WA 98203 | 2020-05-11 |
| 1225505241 | Reverie Aurora Shunny | Counselor | Sunrise Service Inc., 811 Madison Street, Everett, WA 98203 | 2018-10-29 |
| 1205313483 | Kristina Renee Bylenga | Counselor | Compass Health 4526 Federal Avenue M/s # 11, Everett, WA 98203 | 2018-07-20 |
| 1306384300 | Shantijoy Inc | Naturopath | 5208 S 2nd Ave, Everett, WA 98203 | 2017-02-09 |
| 1922545276 | Ekaterina Malinovska Dds Pllc | Dentist | 5920 Evergreen Way Suite E, Everett, WA 98203 | 2017-01-25 |
| 1326404104 | Job Oichoe | Counselor | 4625 Federal Ave, Everett, WA 98203 | 2016-01-08 |
| 1427423292 | Ross Lee Voorhees | Counselor | 4423 S 3rd Ave, Everett, WA 98203 | 2015-12-04 |
| 1447642376 | Adam Schneider | Counselor | 4526 Federal Ave # 40, Everett, WA 98203 | 2015-03-02 |
| Find all providers in zip 98203 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538387931 | Western Washington Medical Group, Inc Ps | Urology | 4310 Colby Ave Ste 203, Everett, WA 98203-2338 | 2007-04-23 |
| 1871515619 | Earl Dan Bardin | Urology | 4225 Hoyt, Ste C, Everett, WA 98203 | 2006-07-24 |
| 1720021140 | Thomas P Cooper | Urology | 1111 Pacific Ave, Everett, WA 98201-4200 | 2006-06-14 |
| 1912954744 | Terry Spark Corwin | Urology | 4310 Colby Ave, Suite 203, Everett, WA 98203-2338 | 2006-05-27 |
| 1144488503 | Stephen Mock | Urology | 3901 Hoyt Ave, Everett, WA 98201-4918 | 2008-06-01 |
| 1265640916 | Stephen J Yanoshak | Urology | 202 Memorial Dr, Suite 2, Everett, PA 15537-7057 | 2007-05-18 |
| 1629194030 | Christopher Robert Hempel | Urology | 3901 Hoyt Ave, Everett, WA 98201-4918 | 2007-03-21 |
| 1841335171 | Yen-huang Chen | Urology | 3901 Hoyt Ave, Everett, WA 98201-4918 | 2007-02-21 |
| 1851463921 | Raymond K Whalen | Urology | 3901 Hoyt Ave, Everett, WA 98201-4918 | 2006-11-14 |
| 1518976414 | Bedford Regional Urology, P.C. | Urology | 202 Memorial Dr, Suite 2, Everett, PA 15537-7057 | 2006-08-07 |
| Find all providers in EVERETT | ||||
Please comment or provide details below to improve the information on GARY STACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.