Provider Demographics
NPI:1043464365
Name:HOFSTETTER, CHRISTOPH PAUL (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPH
Middle Name:PAUL
Last Name:HOFSTETTER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST
Mailing Address - Street 2:CAMPUS BOX 356470, ROOM RR734
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6470
Mailing Address - Country:US
Mailing Address - Phone:507-202-9523
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:CAMPUS BOX 356470, ROOM RR734
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6470
Practice Address - Country:US
Practice Address - Phone:507-202-9523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60464459207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1043464365Medicaid
WA8929820Medicare PIN