=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578575452
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HENRY H CHOU MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1200 N 14TH AVE STE 285
-----------------------------------------------------
City | PASCO
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99301-4195
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-547-0686
-----------------------------------------------------
Fax | 509-547-0524
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1200 N 14TH AVE STE 285
-----------------------------------------------------
City | PASCO
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99301-4195
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-547-0686
-----------------------------------------------------
Fax | 509-547-0524
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | MD00029488
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------