MEDICARE: ROBERT L. STANTON, DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	PO00000357	WA

General Provider Information

NPI Number	:	1174707277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT L. STANTON, DPM

Provider Business Mailing Address
First Line	:	10212 5TH AVE NE
Second Line	:	STE 200
City	:	SEATTLE
State	:	WA
Zip	:	98125-7452
Country	:	US
Telephone Number	:	206-363-1683
Fax Number	:	206-364-1109

Provider Business Practice Location Address
First Line	:	10212 5TH AVE NE
Second Line	:	#200
City	:	SEATTLE
State	:	WA
Zip	:	98125-7471
Country	:	US
Telephone Number	:	206-363-1683
Fax Number	:	206-364-1109

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT L. STANTON
Credential	:	DPM
Telephone Number	:	206-363-1683

Provider Enumeration Date	:	12/26/2007
Last Update Date	:	12/26/2007

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