MEDICARE: MELISSA MIKIKO CHIN MD

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	207R00000X	Internal Medicine Physician	MD16392	RI
2	208M00000X	Hospitalist Physician	MD61076166	WA

General Provider Information

NPI Number	:	1760403224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA MIKIKO CHIN MD

Provider Business Mailing Address
First Line	:	1708 YAKIMA AVE STE 120
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-5300
Country	:	US
Telephone Number	:	253-596-3696
Fax Number	:	253-596-3753

Provider Business Practice Location Address
First Line	:	1708 YAKIMA AVE STE 120
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-5300
Country	:	US
Telephone Number	:	253-596-3696
Fax Number	:	253-596-3753

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	03/31/2021

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Directions to “ MELISSA MIKIKO CHIN MD” Practice Location

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