Healthcare Provider Details

I. General information

NPI: 1558470195
Provider Name (Legal Business Name): KEVIN LAWRENCE SLOAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 11/15/2025
Certification Date: 11/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4731 84TH AVE SE
MERCER ISLAND WA
98040-4322
US

IV. Provider business mailing address

4731 84TH AVE SE
MERCER ISLAND WA
98040-4322
US

V. Phone/Fax

Practice location:
  • Phone: 206-375-2774
  • Fax:
Mailing address:
  • Phone: 206-375-2774
  • Fax: 206-829-9410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD00029132
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberMD00029132
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: