Provider Demographics
NPI:1003352345
Name:CHIN, SAMANTHA ARK (DAHM, EAMP, LAC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ARK
Last Name:CHIN
Suffix:
Gender:F
Credentials:DAHM, EAMP, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 31ST AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-3204
Mailing Address - Country:US
Mailing Address - Phone:206-973-9887
Mailing Address - Fax:
Practice Address - Street 1:509 OLIVE WAY STE 1358
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2549
Practice Address - Country:US
Practice Address - Phone:253-237-2476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC 60714800171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist