Individual
DR. CHI MENG GAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 112TH AVE NE STE C160, BELLEVUE, WA 98004
(425) 453-1039
(425) 453-8955
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 453-1039
(425) 453-8955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00042949
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0178441
LABOR AND INDUSTRIES
WA
05
—
1119114
—
WA
01
—
G8800056
MEDICARE PROVIDER NUMBER
WA
Enumeration date
10/26/2007
Last updated
11/15/2019
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