Provider Demographics
NPI:1386744480
Name:AN, HO CHIN (MPT)
Entity type:Individual
Prefix:
First Name:HO CHIN
Middle Name:
Last Name:AN
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17618 140TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-6800
Mailing Address - Country:US
Mailing Address - Phone:425-402-9772
Mailing Address - Fax:425-402-9443
Practice Address - Street 1:17618 140TH AVE NE
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-6800
Practice Address - Country:US
Practice Address - Phone:425-402-9772
Practice Address - Fax:425-402-9443
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT9040225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA169131OtherLABOR & INDUSTRIES
WA169131OtherLABOR & INDUSTRIES