Provider Demographics
NPI:1720296957
Name:SNOW, CHAD (LMP)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:SNOW
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 3RD AVE
Mailing Address - Street 2:SUITE 1428
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2105
Mailing Address - Country:US
Mailing Address - Phone:206-227-9173
Mailing Address - Fax:
Practice Address - Street 1:1401 3RD AVE
Practice Address - Street 2:SUITE 1428
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2105
Practice Address - Country:US
Practice Address - Phone:206-227-9173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA0000018549171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor