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General NPI Number Information
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NPI Number | 1144414145
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Entity Type | Individual
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Provider Name | MARK LEWIS ANSTADT ARNP
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Gender | Male
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Dates
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Enumeration Date | 09/01/2007
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Last Update Date | 05/18/2018
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Provider Practice Location Address
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Address Line | 904 7TH AVE
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City | SEATTLE
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State | WA
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Zip | 98104
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Country | US
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Telephone | 206-860-5603
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Fax | 206-720-7459
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Provider Business Mailing Address
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Address Line | 2720 E MADISON ST
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City | SEATTLE
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State | WA
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Zip | 98112-4739
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Country | US
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Telephone | 206-720-2315
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Fax | 206-720-2338
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP30007837
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP30007837
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License Number State | WA
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