Provider Demographics
NPI:1225409956
Name:PREMIER SLEEP ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:PREMIER SLEEP ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARSTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-698-1732
Mailing Address - Street 1:636 120TH AVE NE
Mailing Address - Street 2:A204
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3028
Mailing Address - Country:US
Mailing Address - Phone:425-698-1732
Mailing Address - Fax:425-746-0146
Practice Address - Street 1:636 120TH AVE NE
Practice Address - Street 2:A204
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3028
Practice Address - Country:US
Practice Address - Phone:425-698-1732
Practice Address - Fax:425-746-0146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-07
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6409122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6416950001Medicare NSC
WA68899227Medicare PIN