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DR. THOMAS M. STALLONE PSY.D.

Clinical Neuropsychologist

Vancouver, Washington

Provider NPI: 1144296104

Provider Information:
DR. THOMAS M. STALLONE PSY.D.
Gender: M


Practice Location:
100 E 13TH ST SUITE 105 VANCOUVER, WA 98660 US
Tel: 360-696-1646  Fax: 360-571-8460

Business Mailing Address:
100 EAST 13TH STREET, SUITE 105 VANCOUVER, WA 98660 US
Tel: 360-696-1646  Fax: 360-571-8460

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
WAPY1974
X103TC0700XBehavioral Health & Social Service Providers
Psychologist
WAPY1974
X103TH0100XBehavioral Health & Social Service Providers
Psychologist
WAPY1974

Other Provider Identifiers:

IssuerNumberStateType
S22283WA02
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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