Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH00002182 | WA |
N | 111NR0200X | Radiology | CH00002182 | WA |
N | 213ER0200X | Radiology | CH00002182 | WA |
NPI | 1598899643 |
---|---|
Provider Name | Perry L Chinn |
First Address | Tacoma, WA 98406-4940 |
Second Address | Tacoma, WA 98406-4940 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 25/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13536 | LABOR & INDUSTRY (01) | |
2032415 | (05) | WA |
CH4243 | REGENCE BCBS (01) |