Provider Demographics
NPI:1013032846
Name:CHIMES, GARY PHILLIP (MD,PHD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:PHILLIP
Last Name:CHIMES
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 116TH AVE NE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3014
Mailing Address - Country:US
Mailing Address - Phone:425-818-0558
Mailing Address - Fax:888-557-3062
Practice Address - Street 1:1600 116TH AVE NE
Practice Address - Street 2:SUITE 206
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3014
Practice Address - Country:US
Practice Address - Phone:425-818-0558
Practice Address - Fax:888-557-3062
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4347652081S0010X
IL036-1156602081S0010X
WAMD603196302081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR07080018400OtherQUALCHOICE
AR5N905OtherBCBS
ARE5236OtherARKANSAS MEDICAL LICENSE
AR165028001Medicaid
ARP00401878OtherRAILROAD MEDICARE