Provider Demographics
NPI:1346348406
Name:KANTER, PAUL A (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:KANTER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20128
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86341-0128
Mailing Address - Country:US
Mailing Address - Phone:206-498-0636
Mailing Address - Fax:
Practice Address - Street 1:16300 MILL CREEK BLVD
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1737
Practice Address - Country:US
Practice Address - Phone:425-742-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1338152W00000X
AZ1545152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist