Individual
CURTIS M FANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4311 11TH AVE NE STE 200, SEATTLE, WA 98105-6367
(206) 616-4001
(206) 616-3889
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60942523
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164940680
—
WA
Enumeration date
09/05/2017
Last updated
07/21/2022
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