SEATTLE SPORTS & REGENERATIVE MEDICINE PLLC - NPI 1871020933

Q: What is Seattle Sports & Regenerative Medicine PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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About Seattle Sports & Regenerative Medicine Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SEATTLE SPORTS & REGENERATIVE MEDICINE PLLC (NPI 1871020933) is a healthcare organization registered as a family medicine in Seattle, Washington and active in the NPI registry since May 2017. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Mark D Wagner, Owner, as its authorized official.

NPPES Registry Identity

NPI1871020933

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameSEATTLE SPORTS & REGENERATIVE MEDICINE PLLC

Location Address1000 DEXTER AVE N STE 320Seattle, WA 98109-4878

Mailing Address1000 Dexter Ave N Ste 320Seattle, WA 98109-4878 · (206) 486-7837 · Fax (206) 462-7520

Phone(206) 999-8556

Organization SubpartNo

Authorized OfficialMark D WagnerOwner · (206) 999-8556

Enumeration DateMay 18, 2017

Last NPPES UpdateOctober 7, 20212 updates tracked since enumeration

NPPES CertifiedOctober 7, 2021

✔ NPI 1871020933 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WA · MD00022633

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1000 DEXTER AVE N STE 320, Seattle, WA 98109

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2133780

Seattle Sports And Regenerative Medicine · Seattle, WA

Active · expires Apr 4, 2028

CLIA Number50D2133780

Laboratory TypePhysician Office

Certificate Effective DateJuly 19, 2017

Certificate Expiration DateApril 4, 2028

Laboratory DirectorMark D. Wagner

Laboratory Phone(206) 999-8556

Laboratory LocationSeattle Sports And Regenerative Medicine1000 Dexter Ave N Ste 300, Seattle, WA 98109

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINZY BETH BOND SHARMA DPT

Physical Therapist