Basic Information
Provider Information
NPI: 1821124561
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROBERTSON
FirstName: CHRISTINE
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3905
Address2: DEPT. 4202
City: SEATTLE
State: WA
PostalCode: 981243905
CountryCode: US
TelephoneNumber: 3605149060
FaxNumber: 3605149051
Practice Location
Address1: 1135 116TH AVE NE
Address2: SUITE 110
City: BELLEVUE
State: WA
PostalCode: 980044623
CountryCode: US
TelephoneNumber: 4252893105
FaxNumber: 4252893104
Other Information
ProviderEnumerationDate: 02/26/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD00012288WAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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