Basic Information
Provider Information
NPI: 1386805109
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARTNESS
FirstName: CHRISTOPHER
MiddleName: BRINSON
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 19020 33RD AVE W STE 210
Address2:  
City: LYNNWOOD
State: WA
PostalCode: 980364748
CountryCode: US
TelephoneNumber: 4255631500
FaxNumber: 4255631500
Practice Location
Address1: 413 LILLY RD NE
Address2:  
City: OLYMPIA
State: WA
PostalCode: 985065133
CountryCode: US
TelephoneNumber: 6049374603
FaxNumber: 3604937253
Other Information
ProviderEnumerationDate: 06/24/2008
LastUpdateDate: 10/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XMD61169682WAY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
044082801WAL & I - SEATTLE RADIOLOGYOTHER
218232805WA MEDICAID
044081501WAL & I - RADIAOTHER
044081701WAL & I - SWEDISH RADIAOTHER
044082901WAL & I - VANCOUVER RADIOLOGISTSOTHER
044080901WAL & I - RADIAOTHER
044082301WAL & I - EVERGREEN RADIAOTHER
044082501WAL & I - SOUTH SOUND RADIOLOGYOTHER


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