=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053350660
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHAD CHRISTIAN BARRETT DC, MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2006
-----------------------------------------------------
Last Update Date | 06/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 702 S PARK ST
-----------------------------------------------------
City | DEER PARK
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99006-7025
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-262-9000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 722 S BROOKS RD
-----------------------------------------------------
City | MEDICAL LAKE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99022-8696
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-750-3515
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MD61405234
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------