Provider Demographics
NPI:1932361128
Name:KOO, CHRISTINE B (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:B
Last Name:KOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1201 TERRY AVE FL 8
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2735
Mailing Address - Country:US
Mailing Address - Phone:206-287-6300
Mailing Address - Fax:206-341-1250
Practice Address - Street 1:1201 TERRY AVE FL 8
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2735
Practice Address - Country:US
Practice Address - Phone:206-287-6300
Practice Address - Fax:206-341-1250
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD60467924207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2038584Medicaid
WAG8931816Medicare PIN