DR. MARK AARON BROADBENT MD NPI 1841553088

NPI Information

NPI: 1841553088
Provider Name: DR. MARK AARON BROADBENT, MD
Classification: Radiology - 2085N0700X
Entity Type: Individual

Specialization: Neuroradiology

Organization: TRA-MINW, PS

PECOS Registration: Yes

Address:
1304 FAWCETT AVE STE 100
TACOMA, WA
ZIP 98402
Phone: (253) 761-4200
Get Directions

DR. Mark Aaron Broadbent, MD is a neuroradiology radiology in Tacoma, WA with 12 years of experience. The provider is 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. DR. Mark Aaron Broadbent, MD NPI is 1841553088. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduation Year:2012

The provider's business location address is:

1304 FAWCETT AVE STE 100
TACOMA, WA
ZIP 98402
Phone: (253) 761-4200
Fax: (253) 761-4201

The NPI 1841553088 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/22/2012 and was last updated on 8/15/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085N0700X	Radiology	Neuroradiology	MD188795	OREGON	No
2	2085R0202X	Radiology	Diagnostic Radiology	2017008637	MISSOURI	No
3	2085R0202X	Radiology	Diagnostic Radiology	MD60837429	WASHINGTON	No
4	2085R0202X	Radiology	Diagnostic Radiology	MD188795	OREGON	No
5	2085N0700X	Radiology	Neuroradiology	MD60837429	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0389198	OTHER	WASHINGTON	LNI-UAOM
2	0389199	OTHER	WASHINGTON	LNI-DINW
3	0389197	OTHER	WASHINGTON	LNI-TRA KING COUNTY
4	0389196	OTHER	WASHINGTON	LNI-TRA REST OF WA
5	2097736	MEDICAID	WASHINGTON
6	500744919	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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