Healthcare Provider Details

I. General information

NPI: 1437247475
Provider Name (Legal Business Name): MICHAEL A SANTORO MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 S 13TH ST
MOUNT VERNON WA
98274-4107
US

IV. Provider business mailing address

1400 E KINCAID ST
MOUNT VERNON WA
98274-4127
US

V. Phone/Fax

Practice location:
  • Phone: 360-424-7041
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberG89373
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD00019114
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: