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NPI Code Detail

MEDICARE: DR. RICK CHAVEZ

MEDICARE: DR. RICK CHAVEZ
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
1261QD0000XDental Clinic/Center5232WA

General Provider Information

NPI Number : 1912159146
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. RICK CHAVEZ
Provider Business Mailing Address
First Line : 8006 15TH AVE NW
Second Line :
City : SEATTLE
State : WA
Zip : 98117-3601
Country : US
Telephone Number : 206-789-6377
Fax Number :
Provider Business Practice Location Address
First Line : 8006 15TH AVE NW
Second Line :
City : SEATTLE
State : WA
Zip : 98117-3601
Country : US
Telephone Number : 206-789-6377
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : RICK E. CHAVEZ
Credential : D.D.S
Telephone Number : 206-789-6377
Provider Enumeration Date : 10/21/2008
Last Update Date : 10/21/2008

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