Provider Demographics
NPI:1154685600
Name:ROBERTSON, CHRISTOPHER ALAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ALAN
Last Name:ROBERTSON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4138 MORNINGVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-5678
Mailing Address - Country:US
Mailing Address - Phone:916-934-3550
Mailing Address - Fax:
Practice Address - Street 1:433 SW 41ST ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-4926
Practice Address - Country:US
Practice Address - Phone:425-226-5656
Practice Address - Fax:425-271-1488
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006399213ES0103X
WAPO60563468213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery