Healthcare Provider Details

I. General information

NPI: 1679277917
Provider Name (Legal Business Name): CHRISTOPHER GRAHAM CARLSON-BUSE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CHRISTOPHER GRAHAM CARLSON MD

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7315 212TH ST SW STE 101/207
EDMONDS WA
98026-7610
US

IV. Provider business mailing address

PO BOX 741515
LOS ANGELES CA
90074-1515
US

V. Phone/Fax

Practice location:
  • Phone: 425-775-9474
  • Fax: 425-670-3554
Mailing address:
  • Phone: 425-775-9474
  • Fax: 425-670-3554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD70123155
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: