Provider Demographics
NPI:1457460578
Name:SINCLAIR, JOHN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:SINCLAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:J
Other - Middle Name:DAVID
Other - Last Name:SINCLAIR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3130 E MADISON ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4264
Mailing Address - Country:US
Mailing Address - Phone:206-329-2393
Mailing Address - Fax:206-329-9614
Practice Address - Street 1:155 NE 100TH ST
Practice Address - Street 2:STE 402
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-8012
Practice Address - Country:US
Practice Address - Phone:206-729-4300
Practice Address - Fax:206-275-3695
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00034862208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0133008OtherL&I
WAF72190Medicare UPIN
WA0133008OtherL&I