DR. MARK AARON BROADBENT (NPI# 1841553088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841553088 |
| Entity Type | Individual |
| Full Name | DR. MARK AARON BROADBENT |
| Credential | MD |
| Practice Address |
1304 Fawcett Ave Ste 100 Tacoma WA 98402 |
| Mailing Address |
Po Box 1535 Tacoma WA 98401-1535 |
| Practice Telephone | 2537614200 |
| Practice Fax Number | 2537614201 |
| Mailing Telephone | 2537614200 |
| Mailing Fax Number | 2533833553 |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2018-08-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
MD188795 | OR | Allopathic & Osteopathic Physicians |
| Y | 2085N0700X |
Radiology Specialization: Neuroradiology |
MD60837429 | WA | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD188795 | OR | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD60837429 | WA | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
2017008637 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | LNI-UAOM | 0389198 | 01 |
| WA | LNI-TRA REST OF WA | 0389196 | 01 |
| WA | LNI-TRA KING COUNTY | 0389197 | 01 |
| WA | 2097736 | 05 | |
| OR | 500744919 | 05 | |
| WA | LNI-DINW | 0389199 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 222 15th Ave Se, Puyallup, WA 983723754 | 2538414353 | 2535838630 |
| 2502 S Union Ave, Tacoma, WA 984051328 | 2537619482 | 2537596252 |
| Street Address |
1304 FAWCETT AVE STE 100 |
| City | TACOMA |
| State | WA |
| Zip Code | 98402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598746232 | Joon Kyung Song | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2005-11-09 |
| 1487179404 | Trevor Lee Reeves | Physician Assistant | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2017-08-10 |
| 1699228536 | Bridget Ann Lonergan | Registered Nurse | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2016-07-27 |
| 1508213042 | Amanda Maureen Brown | Physician Assistant | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2016-05-14 |
| 1841658598 | Gensuke Akaike | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2016-02-09 |
| 1437577723 | Daniel Van Roekel | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2014-04-03 |
| 1912325473 | Nicholas Zane Conley | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2014-04-02 |
| 1619395100 | Sandhya Jacob | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2014-04-01 |
| 1285060426 | Christopher James Schaller | Physician Assistant | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2013-09-19 |
| 1205196607 | Christopher Selby Green | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402 | 2012-05-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548898638 | Cimberleigh Mclean | Social Worker | 2367 Tacoma Ave S Ofc 211, Tacoma, WA 98402 | 2020-04-01 |
| 1831735802 | Nickolas Justin Wise | Case Manager/Care Coordinator | 1159 Market St, Tacoma, WA 98402 | 2019-11-25 |
| 1841835436 | Michael Roy Bolden | Counselor | 1205 Tacoma Ave S., Suite 1205, Tacoma, WA 98402 | 2019-11-07 |
| 1073024980 | Megan Elizabeth Charron Mourfield | Denturist | 725 St Helens Ave S, Tacoma, WA 98402 | 2017-10-18 |
| 1104367937 | Janelle Santiago | Counselor | Mcdonald Smith Building 110, Uw Autism Center Tacoma, Tacoma, WA 98402 | 2017-03-13 |
| 1891167862 | Tanya Larson Therapy | Community/Behavioral Health | 1102 A. St., Suite 109, (suite 109), Tacoma, WA 98402 | 2015-10-29 |
| 1609242148 | Ashley Lorraine Dahlgren | Peer Specialist | 702 S 14th St., Tacoma, WA 98402 | 2015-08-19 |
| 1821416470 | Nicole Villarreal Mccormick | Acupuncturist | 711 A Ct #100, Tacoma, WA 98402 | 2014-04-01 |
| 1184055824 | Robyn Marie Callahan | Social Worker | 1102 A Street, Suite 202 B, Tacoma, WA 98402 | 2013-12-05 |
| 1679909410 | Kristin Sweet Fischer | Counselor | 708 Market St Unit 411, Tacoma, WA 98402 | 2013-09-25 |
| Find all providers in zip 98402 | ||||
| Taxonomy Code | 2085N0700X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Neuroradiology |
| A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598746232 | Joon Kyung Song | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2005-11-09 |
| 1356607725 | Andrew James Scarano | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402 | 2012-04-10 |
| 1871811869 | Roger Liu | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402 | 2010-05-14 |
| 1619126075 | Nicholas David Krause | Radiology | 1201 Pacific Ave, Suite 400, Tacoma, WA 98402-4301 | 2008-09-10 |
| 1831345842 | William Dale Hwang | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2008-08-09 |
| 1982860508 | Brian Michael Eichinger | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402 | 2008-08-04 |
| 1013173814 | Scott Randall Henneman | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402 | 2008-07-31 |
| 1205095460 | Jeremy Scott Cardinal | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2008-06-03 |
| 1083889919 | John Paul Kim | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402 | 2008-04-22 |
| 1760673958 | Baiju Shah | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2007-08-05 |
| Find all providers in TACOMA | ||||
Please comment or provide details below to improve the information on DR. MARK AARON BROADBENT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.