Healthcare Provider Details

I. General information

NPI: 1033433099
Provider Name (Legal Business Name): CHRISTINA T. EIDE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2010
Last Update Date: 08/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 MADISON ST STE 1440
SEATTLE WA
98104-3538
US

IV. Provider business mailing address

925 SENECA ST MS H8-GME
SEATTLE WA
98101-2742
US

V. Phone/Fax

Practice location:
  • Phone: 206-625-0578
  • Fax: 206-625-9184
Mailing address:
  • Phone: 206-583-6079
  • Fax: 206-583-2307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD60464753
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: