Provider Demographics
NPI:1922046572
Name:HOGNESS, CHRISTOPHER G (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:G
Last Name:HOGNESS
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 945
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:WA
Mailing Address - Zip Code:98862-0945
Mailing Address - Country:US
Mailing Address - Phone:509-996-8180
Mailing Address - Fax:509-996-3374
Practice Address - Street 1:1116 HWY 20
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:WA
Practice Address - Zip Code:98862
Practice Address - Country:US
Practice Address - Phone:509-996-8180
Practice Address - Fax:509-996-3374
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00033035207Q00000X, 207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7103807Medicaid
WA080167687OtherRAILROAD MEDICARE
WA222145OtherSTATE OF WA DEPT OF L&I
WA222145OtherSTATE OF WA DEPT OF L&I
WAG8865195Medicare PIN