Individual
CHASE S IIDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 543-2030
Mailing address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 543-2030
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
IR60449217
WA
Other
Enumeration date
11/12/2015
Last updated
11/12/2015
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