Provider Demographics
NPI:1891730081
Name:SONTROP, ANNEMIEK MARIA (MD)
Entity Type:Individual
Prefix:
First Name:ANNEMIEK
Middle Name:MARIA
Last Name:SONTROP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNEMIEK
Other - Middle Name:MARIA
Other - Last Name:DAUM-SONTROP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1145 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4201
Mailing Address - Country:US
Mailing Address - Phone:206-329-1760
Mailing Address - Fax:
Practice Address - Street 1:3216 NE 45TH PL
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4093
Practice Address - Country:US
Practice Address - Phone:206-525-4000
Practice Address - Fax:206-525-4093
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00038256207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8254989Medicaid
WAH45533Medicare UPIN
WA8864530Medicare PIN