Provider Demographics
NPI:1245385236
Name:STRIDDE, BRADEN CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:BRADEN
Middle Name:CHARLES
Last Name:STRIDDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5400 CARILLON POINT, BUILDING 5000, 4TH FLOOR
Mailing Address - Street 2:SUITE 409
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7357
Mailing Address - Country:US
Mailing Address - Phone:425-202-4709
Mailing Address - Fax:425-576-4102
Practice Address - Street 1:10117 NE 58TH STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7450
Practice Address - Country:US
Practice Address - Phone:425-202-4709
Practice Address - Fax:425-576-4102
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000275312086S0122X
WA27531208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAE35273Medicare UPIN