OrganizationActive
Maksportsmd
NPI 1417469404 · Sports Medicine (Family Medicine) Physician · Bothell, WA
Provider details
- NPI number
- 1417469404
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Abimbolu Makinde, Owner
- License
- 60465979 (WA)
Practice location
19110 Bothell Way Ne Ste 102
Bothell, WA 98011-2970
Phone: (425) 286-8271
Fax: (425) 491-7271
Mailing address
19110 Bothell Way Ne Ste 102
Bothell, WA 98011-2970
Registry dates
- Enumerated
- 2017-10-30
- Last updated
- 2017-10-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.