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Individual

AMELIA CHIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4200 MARY GATES MEMORIAL DR NE APT U253, SEATTLE, WA 98105-5649
(206) 383-9338
Mailing address
4200 MARY GATES MEMORIAL DR NE APT U253, SEATTLE, WA 98105-5649

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DE60470450
WA
1223P0221X
Pediatric Dentistry
Primary
DE60470450
WA
124Q00000X
Dental Hygienist
DH00007833
WA

Other

Enumeration date
03/31/2014
Last updated
06/03/2016
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