Provider Demographics
NPI:1558820563
Name:STEIN, ELLIOT JOSHUA (MD, MSTR)
Entity Type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:JOSHUA
Last Name:STEIN
Suffix:
Gender:M
Credentials:MD, MSTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST BOX 356422. SUITE BB-552
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6422
Mailing Address - Country:US
Mailing Address - Phone:206-685-1397
Mailing Address - Fax:206-685-9394
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6130
Practice Address - Country:US
Practice Address - Phone:206-685-1397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61268063207RC0000X
PAMT218453207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease