Provider Demographics
NPI:1699849703
Name:PASTOR, JOHN F (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:PASTOR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1300 114TH AVE SE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6942
Mailing Address - Country:US
Mailing Address - Phone:425-462-9511
Mailing Address - Fax:426-462-8894
Practice Address - Street 1:1300 114TH AVE SE
Practice Address - Street 2:SUITE 115
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6942
Practice Address - Country:US
Practice Address - Phone:425-462-9511
Practice Address - Fax:426-462-8894
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2017-04-11
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Provider Licenses
StateLicense IDTaxonomies
WAMD000388992084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAH26010Medicare UPIN