Provider Demographics
NPI:1689828345
Name:BADER, CYNTHIA D (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:D
Last Name:BADER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 NORTHUP WAY
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-1463
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14711 NE 29TH PL
Practice Address - Street 2:SUITE #255
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-7666
Practice Address - Country:US
Practice Address - Phone:425-460-5634
Practice Address - Fax:425-885-2913
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7151943-1205208000000X
WAMD60156926208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics