MEDICARE: FANGAEO CHOWSOUN

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	225700000X	Massage Therapist	MA61495998	WA

General Provider Information

NPI Number	:	1982414991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FANGAEO CHOWSOUN

Provider Business Mailing Address
First Line	:	502 SENZ RD
Second Line	:
City	:	SEQUIM
State	:	WA
Zip	:	98382-7904
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 E WASHINGTON ST
Second Line	:
City	:	SEQUIM
State	:	WA
Zip	:	98382-4107
Country	:	US
Telephone Number	:	512-665-0857
Fax Number	:

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

Provider Enumeration Date	:	01/10/2025
Last Update Date	:	01/10/2025

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Directions to “ FANGAEO CHOWSOUN ” Practice Location

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