Individual
SOREN M GANTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4800 SAND POINT WAY NE, SEATTLE, WA 98105-3901
(206) 987-1909
(206) 987-3890
Mailing address
PO BOX 50010, SEATTLE, WA 98105-1010
(206) 987-8450
(206) 987-8484
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD00043059
WA
2080P0208X
Pediatric Infectious Diseases Physician
Primary
MD00043059
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807507400
—
ID
05
—
8452617
—
WA
Enumeration date
05/28/2006
Last updated
05/14/2008
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