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General NPI Number Information
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NPI Number | 1013032846
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Entity Type | Individual
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Provider Name | GARY PHILLIP CHIMES MD,PHD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 02/19/2014
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Provider Practice Location Address
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Address Line | 1600 116TH AVE NE SUITE 206
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City | BELLEVUE
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State | WA
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Zip | 98004-3014
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Country | US
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Telephone | 425-818-0558
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Fax | 888-557-3062
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Provider Business Mailing Address
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Address Line | 1600 116TH AVE NE SUITE 206
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City | BELLEVUE
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State | WA
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Zip | 98004-3014
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Country | US
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Telephone | 425-818-0558
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Fax | 888-557-3062
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | MD434765
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 036-115660
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | MD60319630
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License Number State | WA
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