Healthcare Provider Details

I. General information

NPI: 1336204940
Provider Name (Legal Business Name): EUGENE H CHA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 06/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 N 115TH ST NORTHWEST HOSPITAL AND MEDICAL CENTER
SEATTLE WA
98133
US

IV. Provider business mailing address

PO BOX 50095
SEATTLE WA
98145-5095
US

V. Phone/Fax

Practice location:
  • Phone: 206-368-1008
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD60020931
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: