Healthcare Provider Details

I. General information

NPI: 1578600342
Provider Name (Legal Business Name): CHRISTOPHER A. TULLIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 09/25/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 S DIVISION ST STE 2
SPOKANE WA
99202-1331
US

IV. Provider business mailing address

910 N WASHINGTON ST SUITE 209
SPOKANE WA
99201-2202
US

V. Phone/Fax

Practice location:
  • Phone: 509-474-5858
  • Fax: 509-277-7070
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD00037161
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD00037161
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: