Provider Demographics
NPI:1962451674
Name:MAGARAM, DAVID LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEE
Last Name:MAGARAM
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 1:10700 MERIDIAN AVE N STE 505
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9030
Mailing Address - Country:US
Mailing Address - Phone:206-365-4100
Mailing Address - Fax:206-368-6898
Practice Address - Street 1:1560 N. 115TH
Practice Address - Street 2:SEATTLE BREAST CENTER
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133
Practice Address - Country:US
Practice Address - Phone:206-368-1749
Practice Address - Fax:206-368-1790
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD456282085R0202X
WAMD000378602085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3562MAOtherREGENCE BLUE SHIELD
WA8250540Medicaid
TN4314853OtherBLUECROSS BLUESHIELD
TN1527010Medicaid
3562MAOtherREGENCE BLUE SHIELD
WAA46167Medicare UPIN
A46167Medicare UPIN
300133019Medicare PIN
WA8851593Medicare PIN