Healthcare Provider Details

I. General information

NPI: 1699425256
Provider Name (Legal Business Name): NATHAN JIN CHUNG CHOW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2022
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11011 MERIDIAN AVE N STE 308
SEATTLE WA
98133-8967
US

IV. Provider business mailing address

1314 CRICKLEWOOD LN
SPRING TX
77379-3654
US

V. Phone/Fax

Practice location:
  • Phone: 206-859-5777
  • Fax:
Mailing address:
  • Phone: 832-260-4050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberR80184
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: