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General NPI Number Information
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NPI Number | 1780518837
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Entity Type | Organization
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Legal Business Name | CHAN BRACES
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 19020 BOTHELL WAY NE STE A
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City | BOTHELL
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State | WA
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Zip | 98011-2996
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Country | US
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Telephone | 425-485-9332
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Fax |
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Provider Business Mailing Address
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Address Line | 19020 BOTHELL WAY NE STE A
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City | BOTHELL
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State | WA
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Zip | 98011-2996
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Country | US
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Telephone | 907-738-3204
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | CHRISTIAN KENWORTHY
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Credential |
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Telephone | 469-963-0340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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