Healthcare Provider Details

I. General information

NPI: 1518053701
Provider Name (Legal Business Name): NATASHA LEACOCK CHAU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 W 1ST AVE
TOPPENISH WA
98948-1564
US

IV. Provider business mailing address

PO BOX 190
TOPPENISH WA
98948-0190
US

V. Phone/Fax

Practice location:
  • Phone: 509-865-5600
  • Fax: 509-865-5783
Mailing address:
  • Phone: 509-865-6175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD00038488
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: