Individual
DR. TERENCE T CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3417 ENSIGN RD NE, OLYMPIA, WA 98506-5064
(360) 493-4600
(360) 493-4603
Mailing address
3417 ENSIGN RD NE, OLYMPIA, WA 98506-5064
(360) 493-4600
(360) 493-4603
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00023653
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0076574
L & I
WA
01
—
0381078
L&I-SOUTH SOUND RADIOLOGY
WA
01
—
0386386
L&I-RADIA REST OF WA
WA
05
—
1016369
—
WA
05
—
1021195
—
WA
Enumeration date
10/05/2006
Last updated
01/30/2019
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