MEDICARE: BRIAN WILHOI CHAN DC

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	111N00000X	Chiropractor	CH00034204	WA

General Provider Information

NPI Number	:	1689787913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN WILHOI CHAN DC

Provider Business Mailing Address
First Line	:	159 DENNY WAY
Second Line	:	#306
City	:	SEATTLE
State	:	WA
Zip	:	98178
Country	:	US
Telephone Number	:	206-898-3938
Fax Number	:

Provider Business Practice Location Address
First Line	:	12419 RENTAN AVE S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98178
Country	:	US
Telephone Number	:	206-772-0088
Fax Number	:	206-772-5420

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/08/2007

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