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General NPI Number Information
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NPI Number | 1316166754
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Entity Type | Organization
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Legal Business Name | WASHINGTON SPORTS MEDICINE INSTITUTE, LLC
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12707 120TH AVE NE SUITE 100
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City | KIRKLAND
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State | WA
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Zip | 98034-7500
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Country | US
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Telephone | 425-820-2110
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Fax | 425-820-2111
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Provider Business Mailing Address
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Address Line | 12707 120TH AVE NE SUITE 100
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City | KIRKLAND
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State | WA
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Zip | 98034-7500
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Country | US
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Telephone | 425-820-2110
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Fax | 425-820-2111
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Authorized Official
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Title or Position | PHYSICIAN, LLC MEMBER PARTNER
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Name | DR. STEVEN T BRAMWELL
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Credential | M.D.
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Telephone | 425-820-2110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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