Healthcare Provider Details

I. General information

NPI: 1386674802
Provider Name (Legal Business Name): DAVID Q SANTOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/21/2022
Certification Date: 07/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16259 SYLVESTER RD SW STE 504
BURIEN WA
98166-3059
US

IV. Provider business mailing address

16259 SYLVESTER RD SW STE 504
BURIEN WA
98166-3059
US

V. Phone/Fax

Practice location:
  • Phone: 206-242-3696
  • Fax: 206-246-1078
Mailing address:
  • Phone: 206-242-3696
  • Fax: 206-246-1078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD00030977
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberMD00030977
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: