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General NPI Number Information
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NPI Number | 1194000844
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Entity Type | Organization
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Legal Business Name | STANTON A ERWIN MD PS
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 10/13/2011
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Provider Practice Location Address
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Address Line | 316 MARTIN LUTHER KING JR WAY STE 305
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City | TACOMA
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State | WA
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Zip | 98405-4260
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Country | US
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Telephone | 253-428-0205
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Fax |
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Provider Business Mailing Address
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Address Line | 316 MARTIN LUTHER KING JR WAY STE 305
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City | TACOMA
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State | WA
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Zip | 98405-4260
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STANTON A ERWIN
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Credential | M.D.
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Telephone | 253-428-0205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD00028363
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License Number State | WA
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