Provider Demographics
NPI:1033148192
Name:WASHINGTON SPORTS MEDICINE ASSOCIATES INC
Entity Type:Organization
Organization Name:WASHINGTON SPORTS MEDICINE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:BADGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-516-9613
Mailing Address - Street 1:PO BOX 448
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98073-0448
Mailing Address - Country:US
Mailing Address - Phone:425-516-9613
Mailing Address - Fax:425-732-2705
Practice Address - Street 1:12707 120TH AVE NE
Practice Address - Street 2:SUITE 203
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7500
Practice Address - Country:US
Practice Address - Phone:425-820-1221
Practice Address - Fax:425-821-9362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601669743207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty