MEDICARE: CHRISTIANE ELSBREE M.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCS6314	CA
2	1041C0700X	Clinical Social Worker	LW6096	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	EL0020	OTHER	WA	REGENCE BLUE SHIELD
2	7116109	OTHER	WA	AETNA
3	8912223	OTHER	WA	CRIME VICTIMS COMP. PROGR

General Provider Information

NPI Number	:	1013124817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIANE ELSBREE M.S.W.

Provider Business Mailing Address
First Line	:	1037 NE 65TH ST # 138
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-6655
Country	:	US
Telephone Number	:	206-522-0269
Fax Number	:	206-522-5595

Provider Business Practice Location Address
First Line	:	5306 BALLARD AVE NW STE 207
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-4366
Country	:	US
Telephone Number	:	206-522-0269
Fax Number	:	206-522-5595

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	02/16/2023

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