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NPI Code Detail

MEDICARE: INBALANCE MEDICAL

MEDICARE: INBALANCE MEDICAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QB0002XObesity Medicine (Family Medicine) PhysicianMD00046607WA
2207QS1201XSleep Medicine (Family Medicine) PhysicianMD00046607WA

General Provider Information

NPI Number : 1255650651
Entity Type Code : Organization
Provider Name (Legal Business Name) : INBALANCE MEDICAL
Provider Business Mailing Address
First Line : 1540 140TH AVE NE
Second Line : SUITE 200
City : BELLEVUE
State : WA
Zip : 98005-4579
Country : US
Telephone Number : 206-697-5702
Fax Number :
Provider Business Practice Location Address
First Line : 1540 140TH AVE NE
Second Line : SUITE 200
City : BELLEVUE
State : WA
Zip : 98005-4579
Country : US
Telephone Number : 206-697-5702
Fax Number :
Authorized Official
Title or Position : CEO
Name : GINA CHEN
Credential : M.D.
Telephone Number : 206-697-5702
Provider Enumeration Date : 05/25/2010
Last Update Date : 05/25/2010

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Directions to “INBALANCE MEDICAL ” Practice Location

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