Provider Demographics
NPI:1689746950
Name:TEMPEST, DAVID PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PETER
Last Name:TEMPEST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25608
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84125-0608
Mailing Address - Country:US
Mailing Address - Phone:206-320-4476
Mailing Address - Fax:206-568-7043
Practice Address - Street 1:801 BROADWAY STE 901
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4328
Practice Address - Country:US
Practice Address - Phone:206-860-6656
Practice Address - Fax:206-860-6466
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00018719208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1087600Medicaid
WA19092OtherL & I
WAG000105342Medicare PIN
WA1087600Medicaid
A05762Medicare UPIN