Healthcare Provider Details

I. General information

NPI: 1184121535
Provider Name (Legal Business Name): CHRISTOPHER ALEXANDER MEJIAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2018
Last Update Date: 06/15/2023
Certification Date: 06/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST # NW011
SEATTLE WA
98195-1003
US

IV. Provider business mailing address

1959 NE PACIFIC STREET NW011, BOX 357115
SEATTLE WA
98195-1010
US

V. Phone/Fax

Practice location:
  • Phone: 203-988-7968
  • Fax:
Mailing address:
  • Phone: 203-988-7968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2019011879
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD61386576
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: