MEDICARE: MR. LUTHER KHANH CHAU DC, LMP

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	174400000X	Specialist	MA00019867	WA
2	111N00000X	Chiropractor	60423749	WA
3	225700000X	Massage Therapist	MA00019867	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1649324161	OTHER	WA	NPI

General Provider Information

NPI Number	:	1649324161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LUTHER KHANH CHAU DC, LMP

Provider Business Mailing Address
First Line	:	3214 50TH ST CT NW
Second Line	:	SUITE 203
City	:	GIG HARBOR
State	:	WA
Zip	:	98335
Country	:	US
Telephone Number	:	253-254-5653
Fax Number	:	877-519-9596

Provider Business Practice Location Address
First Line	:	3214 50TH ST CT NW
Second Line	:	SUITE 203
City	:	GIG HARBOR
State	:	WA
Zip	:	98335
Country	:	US
Telephone Number	:	253-254-5653
Fax Number	:	877-519-9596

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

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	12/09/2014

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