Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Seattle Sports & Regenerative Medicine PLLC

Organization Family Medicine Physician · NPI 1871020933

Seattle Sports & Regenerative Medicine PLLC provides Family Medicine Physician services in Seattle, Washington. Licensed in Washington. Registered with an NPI since 2017.

Licensed in
WA
In the registry since
2017
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1000 Dexter Ave N Ste 320
Seattle, WA 98109-4878
Phone: (206) 999-8556
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD00022633 (WA)

Record details

NPI number1871020933
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Wagner — Owner · (206) 999-8556
NPI enumeratedMay 18, 2017
Last updated in NPPESOctober 7, 2021
Certification dateOctober 7, 2021
Mailing address1000 Dexter Ave N Ste 320, Seattle, WA 98109-4878

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