Healthcare Provider Details

I. General information

NPI: 1144453473
Provider Name (Legal Business Name): SOYEUN CHU DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2009
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 GARNET WAY
WARM SPRINGS MT
59756-9700
US

IV. Provider business mailing address

111 N SANDERS ST DEPT 30
HELENA MT
59601-4520
US

V. Phone/Fax

Practice location:
  • Phone: 406-693-7000
  • Fax:
Mailing address:
  • Phone: 406-444-3416
  • Fax: 406-444-3082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number170734
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberDR.0056392
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number02006231A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: