Provider Demographics
NPI:1942511936
Name:BRUBAKER, CHRISTOPHER JOHN (MD, PHD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:BRUBAKER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2825 EASTLAKE AVE E
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3062
Mailing Address - Country:US
Mailing Address - Phone:206-486-4993
Mailing Address - Fax:206-535-6838
Practice Address - Street 1:2825 EASTLAKE AVE E
Practice Address - Street 2:SUITE 120
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3062
Practice Address - Country:US
Practice Address - Phone:206-486-4993
Practice Address - Fax:206-535-6838
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD603017352084P0804X, 2084P0800X, 2084P0800X
ORMD1629982084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry