Provider Demographics
NPI:1285701169
Name:CHAN, SALINA (LAC, ND)
Entity type:Individual
Prefix:DR
First Name:SALINA
Middle Name:
Last Name:CHAN
Suffix:
Gender:F
Credentials:LAC, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:663 S KING ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2937
Mailing Address - Country:US
Mailing Address - Phone:206-292-9646
Mailing Address - Fax:
Practice Address - Street 1:663 S KING ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2937
Practice Address - Country:US
Practice Address - Phone:206-292-9646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002417171100000X
WANT00001277175F00000X
WAMA00014586225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No175F00000XOther Service ProvidersNaturopath
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA262518554OtherTAX IDENTIFICATION NUMBER