Provider Demographics
NPI:1821042813
Name:CANTRELL, ROWIN ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:ROWIN
Middle Name:ELIZABETH
Last Name:CANTRELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 16TH AVE E
Mailing Address - Street 2:SOUND MENTAL HEALTH
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5212
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2710
Practice Address - Street 1:122 16TH AVE E
Practice Address - Street 2:SOUND MENTAL HEALTH
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5212
Practice Address - Country:US
Practice Address - Phone:206-302-2200
Practice Address - Fax:206-302-2710
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-1153942084P0800X
WAMD600026982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL213626Medicare PIN
ILG40416Medicare UPIN