Individual
CHAD DOUGLAS FASHANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.P.
Contact information
Practice address
1612 SW DASH POINT RD, FEDERAL WAY, WA 98023-4530
(253) 835-5678
(253) 835-7342
Mailing address
17041 34TH AVE S, SEATAC, WA 98188-4449
(206) 218-7648
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00017855
WA
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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