Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Maksportsmd

Organization Sports Medicine (Family Medicine) Physician · NPI 1417469404

Maksportsmd is a Sports Medicine (Family Medicine) Physician in Bothell, Washington. Licensed in Washington. Registered with an NPI since 2017.

Licensed in
WA
In the registry since
2017

Practice location Address checks out

19110 Bothell Way NE Ste 102
Bothell, WA 98011-2970
Phone: (425) 286-8271
Fax: (425) 491-7271
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X · Licence 60465979 (WA)

Record details

NPI number1417469404
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Abimbolu Makinde — Owner · (425) 286-8271
NPI enumeratedOctober 30, 2017
Last updated in NPPESOctober 30, 2017
Mailing address19110 Bothell Way Ne Ste 102, Bothell, WA 98011-2970