Provider Demographics
NPI:1407821853
Name:KOSKINEN, SEAN CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:CHRISTOPHER
Last Name:KOSKINEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2300
Mailing Address - Street 2:MSC 1025
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99210-2300
Mailing Address - Country:US
Mailing Address - Phone:509-943-5616
Mailing Address - Fax:509-943-9272
Practice Address - Street 1:888 SWIFT BLVD
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352
Practice Address - Country:US
Practice Address - Phone:509-943-5616
Practice Address - Fax:509-943-9272
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000444642085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR028433Medicaid
WA4646KAOtherREGENCE
WA8462517Medicaid
WA4646KAOtherREGENCE
WA8462517Medicaid