Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 1226 | ME |
N | 207Q00000X | Family Doctor | 1226 | ME |
Y | 207Q00000X | Family Doctor | OP00002175 | WA |
NPI | 1205891637 |
---|---|
Provider Name | Dr. Scott J Chaffin |
First Address | Port Orchard, WA 98366-3711 |
Second Address | Vashon, WA 98070-6584 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 31/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2017265 | (05) | WA |
88677079 | (05) | CO |
E21069 | (02) | CO |