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General NPI Number Information
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NPI Number | 1942511936
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Entity Type | Individual
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Provider Name | CHRISTOPHER JOHN BRUBAKER M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2010
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Last Update Date | 04/12/2016
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Provider Practice Location Address
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Address Line | 2825 EASTLAKE AVE E SUITE 120
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City | SEATTLE
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State | WA
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Zip | 98102-3062
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Country | US
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Telephone | 206-486-4993
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Fax | 206-535-6838
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Provider Business Mailing Address
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Address Line | 2825 EASTLAKE AVE E SUITE 120
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City | SEATTLE
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State | WA
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Zip | 98102-3062
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Country | US
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Telephone | 206-486-4993
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Fax | 206-535-6838
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD60301735
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD60301735
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License Number State | WA
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