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Individual

DR. CHRISTOPHER SELBY GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1304 FAWCETT AVE STE 100, TACOMA, WA 98402
(253) 761-4200
(253) 761-4201
Mailing address
PO BOX 1535, TACOMA, WA 98401-1535
(253) 761-4200
(253) 383-3553

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD191346
OR
2085R0202X
Diagnostic Radiology Physician
MD60721597
WA
2085R0204X
Vascular & Interventional Radiology Physician
MD191346
OR
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD60721597
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0388739
LNI-TRA REST OF WA
WA
01
0388744
LNI-TRA KING COUNTY
WA
01
0388745
LNI-UAOM
WA
01
0388746
LNI-DINW
WA
05
2047933
WA
Enumeration date
05/21/2012
Last updated
03/11/2019
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