Provider Demographics
NPI:1134167026
Name:ROBERT KANTER MD INC PS
Entity type:Organization
Organization Name:ROBERT KANTER MD INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:KANTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-362-0035
Mailing Address - Street 1:2611 NE 125TH ST
Mailing Address - Street 2:#90
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4373
Mailing Address - Country:US
Mailing Address - Phone:206-362-0035
Mailing Address - Fax:
Practice Address - Street 1:2611 NE 125TH ST
Practice Address - Street 2:SUITE 90
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4373
Practice Address - Country:US
Practice Address - Phone:206-362-0035
Practice Address - Fax:206-362-6927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7134299Medicaid
WA7134299Medicaid