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General NPI Number Information
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NPI Number | 1356699789
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Entity Type | Organization
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Legal Business Name | IRENE CHASEN DDS PLLC
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 16784 NE 86TH CT
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City | REDMOND
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State | WA
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Zip | 98052-8689
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Country | US
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Telephone | 206-851-7305
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Fax |
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Provider Business Mailing Address
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Address Line | 16784 NE 86TH CT
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City | REDMOND
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State | WA
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Zip | 98052-8689
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Country | US
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Telephone | 206-851-7305
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. IRENE CHASEN
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Credential | DDS
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Telephone | 206-851-7305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DE 9774
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License Number State | WA
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