MEDICARE: RONNIE S STANGLER, M.D. M.D.

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	2084P0800X	Psychiatry Physician	14741	WA

General Provider Information

NPI Number	:	1518294891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONNIE S STANGLER, M.D. M.D.

Provider Business Mailing Address
First Line	:	1425 WESTERN AVE APT 101
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98101-2036
Country	:	US
Telephone Number	:	206-622-3069
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 WESTERN AVE APT 101
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98101-2036
Country	:	US
Telephone Number	:	206-622-3069
Fax Number	:

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

Provider Enumeration Date	:	11/07/2009
Last Update Date	:	11/07/2009

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