MEDICARE: YVETTE CHAPMAN

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	171M00000X	Case Manager/Care Coordinator		WA

General Provider Information

NPI Number	:	1669708970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVETTE CHAPMAN

Provider Business Mailing Address
First Line	:	3107 MAIN ST # 121
Second Line	:
City	:	UNION GAP
State	:	WA
Zip	:	98903-1845
Country	:	US
Telephone Number	:	509-469-9556
Fax Number	:

Provider Business Practice Location Address
First Line	:	3107 MAIN ST # 121
Second Line	:
City	:	UNION GAP
State	:	WA
Zip	:	98903-1845
Country	:	US
Telephone Number	:	509-469-9556
Fax Number	:

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

Provider Enumeration Date	:	10/20/2009
Last Update Date	:	02/17/2011

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