Provider Demographics
NPI:1700109600
Name:STANLEY KANTOR DO INC PS
Entity Type:Organization
Organization Name:STANLEY KANTOR DO INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:BROOKE
Authorized Official - Last Name:KANTOR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:206-523-7700
Mailing Address - Street 1:9208 ROOSEVELT WAY NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2845
Mailing Address - Country:US
Mailing Address - Phone:206-523-7700
Mailing Address - Fax:206-523-7702
Practice Address - Street 1:9208 ROOSEVELT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2845
Practice Address - Country:US
Practice Address - Phone:206-529-7700
Practice Address - Fax:206-523-7702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-05
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty