Individual
DAVID MARK WASHA
Active
Individual
DAVID MARK WASHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
2535
WI
111NS0005X
Sports Physician Chiropractor
2813
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
279J7WA
BLUE CROSS BLUE SHIELD
MN
01
—
391762498
FED TAX
WI
01
—
391762498015
BLUE CROSS BLUE SHIELD
WI
01
—
P00046865
RAILROAD MEDICARE
—
Enumeration date
12/04/2006
Last updated
05/22/2008
Update your record
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