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General NPI Number Information
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NPI Number | 1700109600
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Entity Type | Organization
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Legal Business Name | STANLEY KANTOR DO INC PS
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Dates
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Enumeration Date | 03/05/2010
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 9208 ROOSEVELT WAY NE
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City | SEATTLE
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State | WA
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Zip | 98115-2845
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Country | US
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Telephone | 206-529-7700
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Fax | 206-523-7702
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Provider Business Mailing Address
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Address Line | 9208 ROOSEVELT WAY NE
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City | SEATTLE
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State | WA
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Zip | 98115-2845
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Country | US
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Telephone | 206-523-7700
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Fax | 206-523-7702
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. STANLEY BROOKE KANTOR
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Credential | DO
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Telephone | 206-523-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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