Organization
STANFORD PRESCOTT MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANFORD PRESCOTT MD (DOCTOR)
(253) 588-7911
Entity
Organization
Contact information
Practice address
1901 S UNION AVE, TACOMA, WA 98405-1702
(253) 459-6200
Mailing address
PO BOX 97115, LAKEWOOD, WA 98497-0115
(253) 588-7911
(253) 984-6774
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD00030232
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1118132
—
WA
01
—
7848PR
BLUE CROSS
WA
Enumeration date
05/09/2007
Last updated
10/09/2007
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