Individual
BEAU FREDERICK MAR CHIBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6140 156TH PL SE, BELLEVUE, WA 98006-5308
(425) 518-1945
Mailing address
6140 156TH PL SE, BELLEVUE, WA 98006-5308
(425) 518-1945
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
CHIBABF107QR
WA
Other
Enumeration date
02/13/2014
Last updated
02/13/2014
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