Organization
MAKSPORTSMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABIMBOLU MAKINDE MD (OWNER)
(425) 286-8271
Entity
Organization
Contact information
Practice address
19110 BOTHELL WAY NE STE 102, BOTHELL, WA 98011-2970
(425) 286-8271
(425) 491-7271
Mailing address
19110 BOTHELL WAY NE STE 102, BOTHELL, WA 98011-2970
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
60465979
WA
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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