Individual provider Active NPI

David Allen Spak, MD

  • Diagnostic Radiology Physician
  • Spokane, WA
National Provider Identifier
1124384474
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD61176199 Issued in WA
Practice address
800 W 5TH Ave
Spokane, WA 99204-2803
Phone
(509) 458-5800
Fax
(509) 473-7511
NPI assigned
Apr 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X R7901 TX
Diagnostic Radiology Physician 2085R0202X M-15934 ID
Diagnostic Radiology Physician 2085R0202X MD61176199 WA Primary

Addresses

Primary practice location

800 W 5TH Ave
Spokane, WA 99204-2803

Mailing address

19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748
Phone (425) 563-1500

Other identifiers 3

IdentifierTypeStateIssuer
389378601MedicaidTX
2189192MedicaidWA
389378602OtherTXOTHER (MEDICAID CSHCN)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WA, OR3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210924001611 ID Practitioner - Diagnostic Radiology 3072862556 Reassigns benefits to 1 organization
I20210924001830 WA Practitioner - Diagnostic Radiology 3072862556 Reassigns benefits to 12 organizations
I20260416002956 OR Practitioner - Diagnostic Radiology 3072862556 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical School at Houston, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integra Imaging PSGroup PAC ID 1355593062, 126 clinicians
Radia Inc P SGroup PAC ID 9931012812, 275 clinicians
Inland Imaging LLCGroup PAC ID 6608763016, 128 clinicians
South Sound Radiologists Inc P SGroup PAC ID 1254229305, 76 clinicians
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

101 W 8TH Ave
Spokane, WA 99204-2307
Phone (509) 363-7745

1593 E Polston Ave
Post Falls, ID 83854-5326
Phone (208) 262-2300

2801 St Anthony Way
Pendleton, OR 97801-3800
Phone (541) 276-5121

3417 Ensign Rd NE
Olympia, WA 98506-5064
Phone (360) 493-4600

4410 106TH St SW
Mukilteo, WA 98275-4700
Phone (425) 493-6000

525 S Cowley St
Spokane, WA 99202-1381
Phone (509) 747-4455

747 Broadway
Seattle, WA 98122-4379
Phone (206) 386-6000

Hospital & facility affiliations

  • Northwest Specialty Hospital Hospital, Post Falls, ID, CCN 130066
  • Lincoln Hospital Hospital, Davenport, WA, CCN 501305
  • Providence Mount Carmel Hospital Hospital, Colville, WA, CCN 501326
  • Swedish Medical Center Hospital, Seattle, WA, CCN 500027
  • Newport Community Hospital Hospital, Newport, WA, CCN 501310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-15934IDMDDiagnostic Radiology Physician
MD61176199WAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Radia Imaging Center at Edmonds LLC Diagnostic Radiology CurrentSince Oct 6, 2021 Accepting new patients
South Sound Radiologists Inc P S Diagnostic Radiology CurrentSince Oct 6, 2021 Accepting new patients
Swedish Health Services CurrentSince Aug 1, 2024 Accepting new patients
Radia Inc P S Diagnostic Radiology CurrentSince Oct 6, 2021 Accepting new patients
Optum Care Washington PLLC CurrentSince Apr 7, 2025 Accepting new patients
Optum Care Washington PLLC CurrentSince Apr 7, 2025 Accepting new patients
Radia Oregon Radiology Medical Group LLC Diagnostic Radiology CurrentSince Jan 12, 2025 Accepting new patients
Swedish Health Services CurrentSince Aug 1, 2024 Accepting new patients
Evergreen Radia LLC Diagnostic Radiology CurrentSince Oct 6, 2021 Accepting new patients
Radia Imaging Center Holdings LLC Diagnostic Radiology CurrentSince Oct 6, 2021 Accepting new patients
Swedish Health Services CurrentSince Aug 1, 2024 Accepting new patients

Locations

1593 E Polston Ave
Post Falls, ID 83854
Phone (208) 262-2300

1200 112th Ave NE
Ste B250
Bellevue, WA 98004
Phone (206) 386-6266

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

21700 Highway 99
Edmonds, WA 98026
Phone (425) 640-4949

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

125 130th St SE
Everett, WA 98208
Phone (425) 341-4800

5708 E Lake Sammamish Pkwy SE
Issaquah, WA 98029
Phone (425) 688-5488

11521 NE 128th St
Ste 200
Kirkland, WA 98034
Phone (425) 952-6100

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

19020 33rd Ave W
Ste 210
Lynnwood, WA 98036
Phone 42556315001

1025 153rd St SE
Ste 200
Mill Creek, WA 98012
Phone (425) 338-4000

4410 106th St SW
Mukilteo, WA 98275
Phone (206) 388-6000

3417 Ensign Rd NE
Olympia, WA 98506
Phone (360) 493-4600

18100 NE Union Hill Rd
Redmond, WA 98052
Phone (425) 498-2020

515 Minor Ave
Ste 110
Seattle, WA 98104
Phone (206) 292-6233

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

500 17th Ave
Seattle, WA 98122
Phone (206) 320-2111

1229 Madison St
Ste 900
Seattle, WA 98104
Phone (206) 292-6233

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

800 W 5th Ave
Spokane, WA 99204
Phone (509) 458-5800

101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181

1215 N McDonald Rd
Ste 101
Spokane Valley, WA 99216
Phone (509) 924-1950

4816 NE Thurston Way
Ste A
Vancouver, WA 98662
Phone (360) 254-4914

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1124384474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 5TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042803",
            "telephone_number": "509-458-5800",
            "fax_number": "509-473-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAK",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "R7901",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-15934",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD61176199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "389378601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2189192",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER (MEDICAID CSHCN)",
            "identifier": "389378602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.