MEDICARE: CHRIS L CHAFFIN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	006836	WA

General Provider Information

NPI Number	:	1013912864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRIS L CHAFFIN DDS

Provider Business Mailing Address
First Line	:	605 E HOLLAND AVE
Second Line	:	STE 214
City	:	SPOKANE
State	:	WA
Zip	:	99218-1246
Country	:	US
Telephone Number	:	509-467-6128
Fax Number	:	509-467-6155

Provider Business Practice Location Address
First Line	:	605 E HOLLAND AVE
Second Line	:	STE 214
City	:	SPOKANE
State	:	WA
Zip	:	99218-1246
Country	:	US
Telephone Number	:	506-467-6128
Fax Number	:	509-467-6155

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	02/17/2022

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