Healthcare Provider Details

I. General information

NPI: 1538337068
Provider Name (Legal Business Name): ROBERT L STANTON DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10212 5TH AVE NE SUITE 200
SEATTLE WA
98125-7452
US

IV. Provider business mailing address

10212 5TH AVENUE NE SUITE 200
SEATTLE WA
98125-7471
US

V. Phone/Fax

Practice location:
  • Phone: 206-363-1683
  • Fax:
Mailing address:
  • Phone: 206-363-1683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberPO00000357
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPO 00000357
License Number StateWA

VIII. Authorized Official

Name: DR. ROBERT L. STANTON
Title or Position: OWNER
Credential: DPM
Phone: 206-363-1683