Healthcare Provider Details

I. General information

NPI: 1780132035
Provider Name (Legal Business Name): DAVID MARK SAX MPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2016
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5470 SHILSHOLE AVE NW
SEATTLE WA
98107-4040
US

IV. Provider business mailing address

555 NE 117TH ST
SEATTLE WA
98125-4929
US

V. Phone/Fax

Practice location:
  • Phone: 360-474-7016
  • Fax:
Mailing address:
  • Phone: 520-237-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number00005912
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61483423
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: