Provider Demographics
NPI:1710306410
Name:BEAUDOIN, CHRISTOPHER JAMES (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:BEAUDOIN
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 1:1959 NE PACIFIC ST RM BB-527
Mailing Address - Street 2:BOX 356421
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6421
Mailing Address - Country:US
Mailing Address - Phone:206-543-3605
Mailing Address - Fax:
Practice Address - Street 1:4300 B ST STE 200
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5933
Practice Address - Country:US
Practice Address - Phone:907-375-3355
Practice Address - Fax:907-375-3351
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK138245207R00000X, 208M00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program