Healthcare Provider Details

I. General information

NPI: 1154429249
Provider Name (Legal Business Name): STANLEY G NEWELL DPM PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 12/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9501 5TH AVE NE
SEATTLE WA
98115-2108
US

IV. Provider business mailing address

9501 5TH AVE NE
SEATTLE WA
98115-2108
US

V. Phone/Fax

Practice location:
  • Phone: 206-527-9160
  • Fax: 206-527-2850
Mailing address:
  • Phone: 206-527-9160
  • Fax: 206-527-2850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: STANLEY GENE NEWELL
Title or Position: PRESIDENT
Credential:
Phone: 206-527-9160