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NPI Code Detail

MEDICARE: DR. DAVID J. GAVARESKI MD

MEDICARE:  DR. DAVID J. GAVARESKI  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD00014503WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5080148056OTHERWARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20130082OTHERWALABOR & INDUSTRIES (REG)
314750OTHERWAREGENCE BLUESHIELD
4423898021OTHERWAGROUP HEALTH COOPERATIVE
68925067OTHERWALABOR & INDUSTRIES (CV)

General Provider Information

NPI Number : 1922055656
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID J. GAVARESKI MD
Provider Business Mailing Address
First Line : 3610 MERIDIAN ST
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-1732
Country : US
Telephone Number : 360-318-8800
Fax Number :
Provider Business Practice Location Address
First Line : 3500 ORCHARD PL
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-1749
Country : US
Telephone Number : 360-671-3900
Fax Number : 360-647-0882
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2006
Last Update Date : 04/27/2026

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Directions to “ DR. DAVID J. GAVARESKI MD” Practice Location

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