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NPI Code Detail

MEDICARE: DR. EVAN DAVID KANTER MD, PHD

MEDICARE: DR. EVAN DAVID KANTER MD, PHD
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
12084P0800XPsychiatry Physician36506WA

General Provider Information

NPI Number : 1821106824
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EVAN DAVID KANTER MD, PHD
Provider Business Mailing Address
First Line : 1660 S COLUMBIAN WAY
Second Line : 116-MHC
City : SEATTLE
State : WA
Zip : 98108-1532
Country : US
Telephone Number : 206-764-2007
Fax Number : 206-764-2572
Provider Business Practice Location Address
First Line : 3639 MARTIN LUTHER KING JR WAY S
Second Line :
City : SEATTLE
State : WA
Zip : 98144-6847
Country : US
Telephone Number : 206-695-7600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2006
Last Update Date : 10/25/2018

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