Provider Demographics
NPI:1982072831
Name:CHAY, RINA
Entity type:Individual
Prefix:
First Name:RINA
Middle Name:
Last Name:CHAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 167TH PL SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-9355
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9245 RAINIER AVE S
Practice Address - Street 2:9245 RAINIER AVE SOUTH
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-5569
Practice Address - Country:US
Practice Address - Phone:206-461-6981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2015-11-20
Deactivation Date:2015-10-05
Deactivation Code:
Reactivation Date:2015-11-20
Provider Licenses
StateLicense IDTaxonomies
WADH60137392124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist