Provider Demographics
NPI:1174707277
Name:ROBERT L. STANTON, DPM
Entity type:Organization
Organization Name:ROBERT L. STANTON, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:STANTON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:206-363-1683
Mailing Address - Street 1:10212 5TH AVE NE
Mailing Address - Street 2:STE 200
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-7452
Mailing Address - Country:US
Mailing Address - Phone:206-363-1683
Mailing Address - Fax:206-364-1109
Practice Address - Street 1:10212 5TH AVE NE
Practice Address - Street 2:#200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-7471
Practice Address - Country:US
Practice Address - Phone:206-363-1683
Practice Address - Fax:206-364-1109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO00000357332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4711020001Medicare NSC
WA000105151Medicare PIN