Provider Demographics
NPI:1669422994
Name:BIRKBY, CRAIG STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:STEVEN
Last Name:BIRKBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3913
Mailing Address - Street 2:MS 310019
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-3913
Mailing Address - Country:US
Mailing Address - Phone:206-215-3300
Mailing Address - Fax:216-215-3301
Practice Address - Street 1:1229 MADISON STREET
Practice Address - Street 2:SUITE 1090
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-215-3300
Practice Address - Fax:206-215-3301
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00025324207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1043975Medicaid
WAG8859872Medicare PIN
WA1043975Medicaid