Provider Demographics
NPI:1205594652
Name:SKOORSMITH, CHRISTIAN NEILL (MA, BCH)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:NEILL
Last Name:SKOORSMITH
Suffix:
Gender:M
Credentials:MA, BCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9451 35TH AVE SW STE 200
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-3871
Mailing Address - Country:US
Mailing Address - Phone:206-457-9275
Mailing Address - Fax:
Practice Address - Street 1:9451 35TH AVE SW STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-3871
Practice Address - Country:US
Practice Address - Phone:206-457-9275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHP60696163174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist