Healthcare Provider Details

I. General information

NPI: 1245312420
Provider Name (Legal Business Name): CHRISTOPHER A DI RE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N 34TH ST STE 101
SEATTLE WA
98103-8856
US

IV. Provider business mailing address

9200 S DADELAND BLVD STE 800
MIAMI FL
33156-2758
US

V. Phone/Fax

Practice location:
  • Phone: 206-838-1777
  • Fax: 206-838-1771
Mailing address:
  • Phone: 786-530-3820
  • Fax: 305-675-3378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD00038696
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: