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Individual

CHRISTOPHER L FELLOWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6600
Mailing address
1100 9TH AVE, MS: M4-PA, SEATTLE, WA 98101-2756
(206) 583-6025
(206) 515-5886

Taxonomy

Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
Primary
MD00020788
WA
207RC0000X
Cardiovascular Disease Physician
MD00020788
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0039571
L & I
WA
01
300093517
RAILROAD MEDICARE
WA
01
805441800
IDAHO MEDICAID
WA
05
8592602
WA
01
FE4333
INDIVIDUAL BLUE SHIELD
WA
01
MD788WA
ALASKA MEDICAID
WA
01
US0861430
AETNA SPECIALIST PIN
WA
Enumeration date
02/10/2006
Last updated
04/09/2012
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