Provider Demographics
NPI:1689654212
Name:DENKINGER, TODD M (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:M
Last Name:DENKINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 2ND AVE S
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-4102
Mailing Address - Country:US
Mailing Address - Phone:803-290-8633
Mailing Address - Fax:
Practice Address - Street 1:1716 W MARINE VIEW DR STE C
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-2098
Practice Address - Country:US
Practice Address - Phone:425-259-0212
Practice Address - Fax:425-259-0209
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20808207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC208082Medicaid
SC208082Medicaid
SCG848543426Medicare ID - Type Unspecified