Provider Demographics
NPI:1245817857
Name:STARK, CAIN WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:CAIN
Middle Name:WILLIAM
Last Name:STARK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CAIN
Other - Middle Name:WILLIAM
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1917 7TH AVE W
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-2815
Mailing Address - Country:US
Mailing Address - Phone:920-360-0363
Mailing Address - Fax:
Practice Address - Street 1:600 BROADWAY STE 270
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5392
Practice Address - Country:US
Practice Address - Phone:206-381-0269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61678578207L00000X
WAMD61678578207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology