Provider Demographics
NPI:1093245359
Name:FOOTE, CHANEY (RDH, BS)
Entity Type:Individual
Prefix:MRS
First Name:CHANEY
Middle Name:
Last Name:FOOTE
Suffix:
Gender:F
Credentials:RDH, BS
Other - Prefix:
Other - First Name:CHANEY
Other - Middle Name:
Other - Last Name:HUBBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3475 N SARATOGA ST
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98278-8800
Mailing Address - Country:US
Mailing Address - Phone:360-257-2302
Mailing Address - Fax:
Practice Address - Street 1:3475 N SARATOGA ST
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98278-4927
Practice Address - Country:US
Practice Address - Phone:360-257-2302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7794124Q00000X
WA60575941124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist