Provider Demographics
NPI: | 1821179557 |
---|---|
Name: | PRICE, CHRISTINE H (MD) |
Entity Type: | Individual |
Prefix: | |
First Name: | CHRISTINE |
Middle Name: | H |
Last Name: | PRICE |
Suffix: | |
Gender: | F |
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: | 1229 MADISON ST |
Mailing Address - Street 2: | STE 1440 |
Mailing Address - City: | SEATTLE |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98104-3538 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 206-381-0269 |
Mailing Address - Fax: | 206-829-2083 |
Practice Address - Street 1: | 3005 112TH AVE NE |
Practice Address - Street 2: | SUITE 210 |
Practice Address - City: | BELLEVUE |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98004-8015 |
Practice Address - Country: | US |
Practice Address - Phone: | 425-899-3455 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-10-18 |
Last Update Date: | 2020-01-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WA | MD00046951 | 207L00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
WA | 0039515 | Other | LABOR AND INDUSTRIES# |
WA | 4878PR | Other | BLUE SHIELD# |
WA | P00394657 | Other | RAILROAD MC# |
WA | 8477994 | Medicaid | |
WA | 8875071 | Medicare PIN | |
WA | 8477994 | Medicaid | |
WA | 8863036 | Medicare PIN |