| Maksportsmd | |
|
19110 Bothell Way Ne Ste 102 Bothell WA 98011-2970 | |
| (425) 286-8271 | |
| (425) 491-7271 |
| Full Name | Maksportsmd |
|---|---|
| Speciality | Family Medicine |
| Location | 19110 Bothell Way Ne Ste 102, Bothell, Washington |
| Authorized Official Name and Position | Abimbolu Makinde (OWNER) |
| Authorized Official Contact | 4252868271 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maksportsmd 19110 Bothell Way Ne Ste 102 Bothell WA 98011-2970 Ph: () - | Maksportsmd 19110 Bothell Way Ne Ste 102 Bothell WA 98011-2970 Ph: (425) 286-8271 |
| NPI Number | 1417469404 |
|---|---|
| Provider Enumeration Date | 10/30/2017 |
| Last Update Date | 10/30/2017 |
| Medicare PECOS PAC ID | 9739448234 |
|---|---|
| Medicare Enrollment ID | O20180108002433 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417469404 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | 60465979 (Washington) | Primary |
| Provider Name | Abimbolu S. Makinde |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1669769337 PECOS PAC ID: 7618285982 Enrollment ID: I20180108002696 |
| Provider Name | Yanqun Bu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457697526 PECOS PAC ID: 0840545141 Enrollment ID: I20180608001137 |
| Provider Name | Amanda S Macklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740707967 PECOS PAC ID: 2567737182 Enrollment ID: I20200529000614 |
| Provider Name | Jessica Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851069538 PECOS PAC ID: 1355730607 Enrollment ID: I20211108002898 |
King County Public Hospital District No 2 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10131 Main St, Bothell, WA 98011 Phone: 425-485-3955 Fax: 425-485-1476 | |
Murray A Beighton Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 707 228th St Sw, Bothell, WA 98021 Phone: 425-742-7953 Fax: 425-742-3683 | |
Locknane Athletic Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18518 Bothell Way Ne Ste C, Bothell, WA 98011 Phone: 425-368-4242 Fax: 425-368-4243 | |
Western Washington Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1909 214th St Se, Suite 211, Bothell, WA 98021 Phone: 425-420-1655 | |
Kaiser Foundation Health Plan Of Washington Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11913 Ne 195th St, Bothell, WA 98011 Phone: 425-489-3100 Fax: 425-489-3183 | |
Dr. Jaclyn Phan & Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1912 201st Pl Se, Suite 204, Bothell, WA 98012 Phone: 425-485-6812 Fax: 425-485-6813 |