Provider Demographics
NPI:1124759899
Name:STENEKER FAMILY MEDICINE
Entity type:Organization
Organization Name:STENEKER FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SJARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:STENEKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-819-4664
Mailing Address - Street 1:20004 87TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-6275
Mailing Address - Country:US
Mailing Address - Phone:206-819-4664
Mailing Address - Fax:425-412-3281
Practice Address - Street 1:19987 1ST AVE S STE 102
Practice Address - Street 2:
Practice Address - City:NORMANDY PARK
Practice Address - State:WA
Practice Address - Zip Code:98148-2400
Practice Address - Country:US
Practice Address - Phone:206-944-1500
Practice Address - Fax:425-412-3281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty