1821179557 NPI number — CHRISTINE H PRICE MD

Table of content: MISS SAMANTHA BROOKE ALBANESE CPHT (NPI 1457080046)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821179557 NPI number — CHRISTINE H PRICE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRICE
Provider First Name:
CHRISTINE
Provider Middle Name:
H
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821179557
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/29/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1229 MADISON ST
Provider Second Line Business Mailing Address:
STE 1440
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98104-3538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-381-0269
Provider Business Mailing Address Fax Number:
206-829-2083

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3005 112TH AVE NE
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98004-8015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-899-3455
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  MD00046951 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0039515 . This is a "LABOR AND INDUSTRIES#" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 4878PR . This is a "BLUE SHIELD#" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: P00394657 . This is a "RAILROAD MC#" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 8477994 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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