Healthcare Provider Details

I. General information

NPI: 1245385236
Provider Name (Legal Business Name): BRADEN CHARLES STRIDDE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 01/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10117 NE 58TH STREET SUITE 100
KIRKLAND WA
98033-7450
US

IV. Provider business mailing address

5400 CARILLON POINT, BUILDING 5000, 4TH FLOOR SUITE 409
KIRKLAND WA
98033-7357
US

V. Phone/Fax

Practice location:
  • Phone: 425-202-4709
  • Fax: 425-576-4102
Mailing address:
  • Phone: 425-202-4709
  • Fax: 425-576-4102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number27531
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberMD00027531
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: