Provider Demographics
NPI:1902199847
Name:ANTOS, BARRY PAUL
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:PAUL
Last Name:ANTOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2661 SW MYRTLE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98106-1753
Mailing Address - Country:US
Mailing Address - Phone:360-441-1611
Mailing Address - Fax:
Practice Address - Street 1:20903 70TH AVE W
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7201
Practice Address - Country:US
Practice Address - Phone:425-672-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health