Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223X0400X | Orthodontists | 60738208 | WA |
NPI | 1053824458 |
---|---|
Provider Name | Chirag Vilas Chawan |
First Address | Pasco, WA 99301-9822 |
Second Address | Pasco, WA 99301-9822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2017 |
Last Update Date | 17/03/2018 |