Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0202X | Pediatric Cardiologist | MD60284228 | WA |
Y | 2080P0203X | Pediatric Critical Care Doctor | MD60284228 | WA |
NPI | 1124288139 |
---|---|
Provider Name | Titus Chan |
First Address | Seattle, WA 98105-3901 |
Second Address | Seattle, WA 98105-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2008 |
Last Update Date | 15/03/2014 |