Stephen Michael Panteleakos, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A161324072 Issued in WA

Practice address

12021 Northup Way Ste 102
Bellevue, WA 98005-1931

Phone

(425) 882-2122

NPI assigned

Jul 3, 2020

Last updated

Jun 26, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1593734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1700403938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10709 VALLEY VIEW RD UNIT A206",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113083",
            "telephone_number": "206-353-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 NORTHUP WAY STE 102",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051931",
            "telephone_number": "425-882-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTELEAKOS",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-03",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "A161324072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashul Pandhi, M.D.
• Kerilyn Pandorf, SLP
• Ioana Daniela Panduru, LACEMP
• Dennis Howard Pang, MD
• Arshdeep Kaur Pannu, DDS
• Stella Rose Papp, PT
• Panagiota Pappas, LMP
• Paramjyoti Paramjyoti, LMP
• Leilani D Paras, MD
• Russell F Paravecchio, DMD

• Athletic Trainer in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Athletic Trainer in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.