Healthcare Provider Details

I. General information

NPI: 1447309752
Provider Name (Legal Business Name): DAVID HONARI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11511 NE 10TH ST
BELLEVUE WA
98004-8578
US

IV. Provider business mailing address

11511 NE 10TH ST
BELLEVUE WA
98004-8578
US

V. Phone/Fax

Practice location:
  • Phone: 425-502-3000
  • Fax: 425-502-3589
Mailing address:
  • Phone: 425-502-3000
  • Fax: 425-502-3589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD00040096
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberMD00040096
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: