Healthcare Provider Details

I. General information

NPI: 1205594652
Provider Name (Legal Business Name): CHRISTIAN NEILL SKOORSMITH MA, BCH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2021
Last Update Date: 12/02/2021
Certification Date: 12/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9451 35TH AVE SW STE 200
SEATTLE WA
98126-3871
US

IV. Provider business mailing address

9451 35TH AVE SW STE 200
SEATTLE WA
98126-3871
US

V. Phone/Fax

Practice location:
  • Phone: 206-457-9275
  • Fax:
Mailing address:
  • Phone: 206-457-9275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberHP60696163
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: