Provider Demographics
NPI:1316166754
Name:WASHINGTON SPORTS MEDICINE INSTITUTE, LLC
Entity type:Organization
Organization Name:WASHINGTON SPORTS MEDICINE INSTITUTE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN, LLC MEMBER PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:BRAMWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-820-2110
Mailing Address - Street 1:12707 120TH AVE NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7500
Mailing Address - Country:US
Mailing Address - Phone:425-820-2110
Mailing Address - Fax:425-820-2111
Practice Address - Street 1:12707 120TH AVE NE
Practice Address - Street 2:SUITE 100
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7500
Practice Address - Country:US
Practice Address - Phone:425-820-2110
Practice Address - Fax:425-820-2111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center