MEDICARE: DR. MICHAEL A STHAY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD99923734	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417943218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL A STHAY MD

Provider Business Mailing Address
First Line	:	PO BOX 50095
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98145-5095
Country	:	US
Telephone Number	:	206-543-6420
Fax Number	:

Provider Business Practice Location Address
First Line	:	4915 25TH AVE. NE
Second Line	:	STE. 300-W
City	:	SEATTLE
State	:	WA
Zip	:	98105-5668
Country	:	US
Telephone Number	:	206-525-7777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	02/05/2016

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