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NPI Code Detail

MEDICARE: DR. CHRISTINE MYUNG-SOOK CHA MD

MEDICARE: DR. CHRISTINE MYUNG-SOOK CHA MD
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
12085R0001XRadiation Oncology PhysicianMD36543WA
22085R0001XRadiation Oncology PhysicianMD24657OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053313817
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTINE MYUNG-SOOK CHA MD
Provider Business Mailing Address
First Line : 1115 SE 164TH AVE DEPT 358
Second Line :
City : VANCOUVER
State : WA
Zip : 98683-8004
Country : US
Telephone Number : 360-729-1412
Fax Number : 360-729-3025
Provider Business Practice Location Address
First Line : 3301 SQUALICUM PKWY
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-1919
Country : US
Telephone Number : 360-788-8222
Fax Number : 360-788-7759
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 03/08/2022

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