Provider Demographics
NPI:1326154626
Name:SCHIFF, STAN R (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:STAN
Middle Name:R
Last Name:SCHIFF
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 N 200TH ST STE 214A
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3213
Mailing Address - Country:US
Mailing Address - Phone:206-526-2332
Mailing Address - Fax:206-526-2335
Practice Address - Street 1:1207 N 200TH ST STE 214A
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3213
Practice Address - Country:US
Practice Address - Phone:206-526-2332
Practice Address - Fax:206-526-2335
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00025574174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1047091Medicaid
A66652Medicare UPIN
WAA66652Medicare UPIN
WA000109191Medicare PIN