MEDICARE: MELISSA S CHINN DO

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
1	207V00000X	Obstetrics & Gynecology Physician	OP00001920	WA
2	207VG0400X	Gynecology Physician	OP00001921	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336125343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA S CHINN DO

Provider Business Mailing Address
First Line	:	PO BOX 1407
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273-1407
Country	:	US
Telephone Number	:	360-824-5278
Fax Number	:	888-281-2979

Provider Business Practice Location Address
First Line	:	111 S 12TH ST
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98274-4000
Country	:	US
Telephone Number	:	360-678-0831
Fax Number	:	360-678-0583

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	04/24/2023

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Directions to “ MELISSA S CHINN DO” Practice Location

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