Healthcare Provider Details

I. General information

NPI: 1396723235
Provider Name (Legal Business Name): MARC ALAN CHING RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 05/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4727 DENVER AVE S
SEATTLE WA
98134-2316
US

IV. Provider business mailing address

14442 124TH AVE NE
KIRKLAND WA
98034-4801
US

V. Phone/Fax

Practice location:
  • Phone: 206-763-2626
  • Fax: 206-767-1397
Mailing address:
  • Phone: 425-821-7899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00040223
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: