Provider Demographics
NPI:1225575384
Name:STANLEY, ERIK J (EMT)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:J
Last Name:STANLEY
Suffix:
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6730 SE SKYCREST LN
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-8787
Mailing Address - Country:US
Mailing Address - Phone:360-871-2458
Mailing Address - Fax:
Practice Address - Street 1:6730 SE SKYCREST LN
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-8787
Practice Address - Country:US
Practice Address - Phone:360-871-2458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic