Healthcare Provider Details

I. General information

NPI: 1003790486
Provider Name (Legal Business Name): ANTON POWER DO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 ANDOVER PARK W STE 20098188
TUKWILA WA
98188-3379
US

IV. Provider business mailing address

555 ANDOVER PARK W STE 20098188
TUKWILA WA
98188-3379
US

V. Phone/Fax

Practice location:
  • Phone: 510-999-0590
  • Fax:
Mailing address:
  • Phone: 510-999-0590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: ANTON POWER
Title or Position: ADDICTION PSYCHIATRY
Credential:
Phone: 253-234-7801