Healthcare Provider Details

I. General information

NPI: 1235184656
Provider Name (Legal Business Name): ALEX W CANTAFIO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 S 5TH ST STE 1P
TACOMA WA
98405-4210
US

IV. Provider business mailing address

1003 S 5TH ST STE 1P
TACOMA WA
98405-4210
US

V. Phone/Fax

Practice location:
  • Phone: 253-403-6825
  • Fax: 253-864-2847
Mailing address:
  • Phone: 253-403-6825
  • Fax: 253-864-2847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number01083446A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number60067814
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: