Provider Demographics
NPI:1437157823
Name:SMITH, CHRISTOPHER D (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:D
Last Name:SMITH
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 1:990 SYLVAN WAY
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-2851
Mailing Address - Country:US
Mailing Address - Phone:360-479-3657
Mailing Address - Fax:360-373-7616
Practice Address - Street 1:990 SYLVAN WAY
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-2851
Practice Address - Country:US
Practice Address - Phone:360-479-3657
Practice Address - Fax:360-373-7616
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD187597207L00000X
WAMD00034274207L00000X
GA082131207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA91084721528OtherKPS
WA116815OtherLABOR AND INDUSTRIES
WA016487001OtherGROUP HEALTH CORP
WASM5842OtherREGENCE BLUE SHIELD
WA050056355OtherRAILROAD MEDICARE
WA8216582Medicaid
WA910847215OtherPREMERA BLUE CROSS
WA8934014OtherVITIMS OF CRIME
WA910847215OtherUNIFORM MEDICAL
WA8216582Medicaid
WA8934014OtherVITIMS OF CRIME