Organization Active NPI

Steneker Family Medicine

  • Family Medicine Physician
  • Normandy Park, WA
National Provider Identifier
1124759899
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
STENEKER FAMILY MEDICINE
Practice address
19987 1St Ave S Ste 102
Normandy Park, WA 98148-2400
Phone
(206) 944-1500
Fax
(425) 412-3281
NPI assigned
Jun 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sjardo Steneker, MDNPI 1346444296
Title
Owner
Phone
(206) 819-4664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

19987 1St Ave S Ste 102
Normandy Park, WA 98148-2400

Mailing address

20004 87TH Ave SW
Vashon, WA 98070-6275
Phone (206) 819-4664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221222000717 WA Part B Supplier - Clinic/Group Practice 0345610929 Receives reassigned benefits from 1 practitioner
Practice locations: Normandy Park, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2258268Steneker Family Medicine19987 1St Ave S Ste 102, Normandy Park, WA 98148Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

630 SW 153rd St
Ste 106
Burien, WA 98166
Phone (206) 878-8600

19987 1st Ave S
Ste 102
Normandy Park, WA 98148
Phone (206) 824-7200

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1124759899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20004 87TH AVE SW",
            "city": "VASHON",
            "state": "WA",
            "postal_code": "980706275",
            "telephone_number": "206-819-4664",
            "fax_number": "425-412-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19987 1ST AVE S STE 102",
            "city": "NORMANDY PARK",
            "state": "WA",
            "postal_code": "981482400",
            "telephone_number": "206-944-1500",
            "fax_number": "425-412-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STENEKER FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "STENEKER",
        "authorized_official_first_name": "SJARDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-819-4664",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normandy Park, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.