Individual
CHRISTOPHER L IDEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 17TH AVE FL 5, SEATTLE, WA 98122-5788
(206) 320-2800
(206) 320-2827
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD60778599
WA
208100000X
Physical Medicine & Rehabilitation Physician
ML60560262
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881081560
—
WA
Enumeration date
04/21/2015
Last updated
08/15/2019
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