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General NPI Number Information
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NPI Number | 1073931275
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Entity Type | Individual
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Provider Name | EDWARD CHESNUTIS III DPM
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Gender | Male
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Dates
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Enumeration Date | 04/03/2014
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 904 7TH AVE
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City | SEATTLE
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State | WA
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Zip | 98104-1132
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Country | US
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Telephone | 206-860-4457
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Fax | 206-860-5434
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Provider Business Mailing Address
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Address Line | PO BOX 5127
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City | EVERETT
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State | WA
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Zip | 98206-5127
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Country | US
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Telephone | 206-860-5414
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Fax | 206-720-8462
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO60757497
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License Number State | WA
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