MEDICARE: DR. CHRISTOFER AARON STRODE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	01054612A	IN
2	207P00000X	Emergency Medicine Physician	MD00000047587	WA

General Provider Information

NPI Number	:	1649268871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOFER AARON STRODE MD

Provider Business Mailing Address
First Line	:	413 LILLY RD NE
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98506-5133
Country	:	US
Telephone Number	:	360-493-4554
Fax Number	:

Provider Business Practice Location Address
First Line	:	413 LILLY RD NE
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98506-5133
Country	:	US
Telephone Number	:	360-493-4554
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	10/31/2013

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