1073857033 NPI number — MRS. CHELSEA CAROLINE SAUNDERS LMP

Table of content: MRS. CHELSEA CAROLINE SAUNDERS LMP (NPI 1073857033)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073857033 NPI number — MRS. CHELSEA CAROLINE SAUNDERS LMP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAUNDERS
Provider First Name:
CHELSEA
Provider Middle Name:
CAROLINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHILCOAT
Provider Other First Name:
CHELSEA
Provider Other Middle Name:
CAROLINE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1073857033
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/10/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21009 76TH AVE W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDMONDS
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98026-7126
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-672-2910
Provider Business Mailing Address Fax Number:
425-778-1872

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21009 76TH AVE W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDMONDS
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98026-7126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-672-2910
Provider Business Practice Location Address Fax Number:
425-778-1872
Provider Enumeration Date:
11/15/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  MA60320892 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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