Provider Demographics
NPI:1407818255
Name:CHIEM, ANDY VAN (DC)
Entity type:Individual
Prefix:MR
First Name:ANDY
Middle Name:VAN
Last Name:CHIEM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 S EDDY ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-3136
Mailing Address - Country:US
Mailing Address - Phone:206-709-4006
Mailing Address - Fax:
Practice Address - Street 1:3800 S EDDY ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-3136
Practice Address - Country:US
Practice Address - Phone:206-709-4006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA352257051111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor