Organization
BROADWAY SPORTS & INTERNAL MEDICINE P S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY RICHARD SCHUSTER M.D. (PHYSICIAN)
(206) 215-2288
Entity
Organization
Contact information
Practice address
1600 116TH AVE NE, SUITE 202, BELLEVUE, WA 98004-3014
(206) 215-2288
(206) 215-2289
Mailing address
1600 116TH AVE NE, SUITE 202, BELLEVUE, WA 98004-3014
(206) 215-2288
(206) 215-2289
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
MD0019545
WA
207R00000X
Internal Medicine Physician
Primary
MD0019545
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD0019545
WA STATE LICENSE
WA
Enumeration date
12/05/2006
Last updated
07/28/2025
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