Organization
BIOSPORTS NORTHWEST PLLC
Active
Other names
BioSports Northwest
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENIS BRYAN DICKS (CO OWNER)
(206) 947-8050
Entity
Organization
Contact information
Practice address
16007 NE 8TH ST, SUITE 200, BELLEVUE, WA 98008
(425) 985-8915
Mailing address
16007 NE 8TH ST, SUITE 200, BELLEVUE, WA 98008
(425) 985-8915
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
PT00002943
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8859607
MEDICARE #
WA
Enumeration date
05/26/2006
Last updated
06/17/2008
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