Healthcare Provider Details

I. General information

NPI: 1821653049
Provider Name (Legal Business Name): KATRINA CHIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2019
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 116TH AVE NE
BELLEVUE WA
98004-4604
US

IV. Provider business mailing address

1035 116TH AVE NE
BELLEVUE WA
98004-4604
US

V. Phone/Fax

Practice location:
  • Phone: 425-454-3366
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD61358503
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMDR7727
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: