Healthcare Provider Details

I. General information

NPI: 1558243865
Provider Name (Legal Business Name): TORI MEI CHEBOTAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 N DIVISION ST
AUBURN WA
98001-4939
US

IV. Provider business mailing address

PO BOX 920140
DALLAS TX
75392-0140
US

V. Phone/Fax

Practice location:
  • Phone: 253-833-7711
  • Fax:
Mailing address:
  • Phone: 877-346-2211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61660860
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60932626
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: