Provider Demographics
NPI:1194805937
Name:MIDDLE WAY INTERNAL MEDICINE, PLLC
Entity type:Organization
Organization Name:MIDDLE WAY INTERNAL MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARI
Authorized Official - Middle Name:LISA
Authorized Official - Last Name:DAVISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-322-5498
Mailing Address - Street 1:3121 E MADISON ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4262
Mailing Address - Country:US
Mailing Address - Phone:206-322-5498
Mailing Address - Fax:206-322-5618
Practice Address - Street 1:3121 E MADISON ST
Practice Address - Street 2:SUITE 204
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4262
Practice Address - Country:US
Practice Address - Phone:206-322-5498
Practice Address - Fax:206-322-5618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care