Healthcare Provider Details

I. General information

NPI: 1689746950
Provider Name (Legal Business Name): DAVID PETER TEMPEST MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 05/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 BROADWAY STE 901
SEATTLE WA
98122-4328
US

IV. Provider business mailing address

PO BOX 25608
SALT LAKE CITY UT
84125-0608
US

V. Phone/Fax

Practice location:
  • Phone: 206-860-6656
  • Fax: 206-860-6466
Mailing address:
  • Phone: 206-320-4476
  • Fax: 206-568-7043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD00018719
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: