Provider Demographics
NPI:1114020146
Name:CHIN, GEORGE N (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:N
Last Name:CHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:N
Other - Last Name:CHIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10564 5TH AVE NE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-7200
Mailing Address - Country:US
Mailing Address - Phone:206-365-5800
Mailing Address - Fax:206-364-2072
Practice Address - Street 1:10564 5TH AVE NE
Practice Address - Street 2:SUITE 102
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-7200
Practice Address - Country:US
Practice Address - Phone:206-365-5800
Practice Address - Fax:206-364-2072
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00015647207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8852975Medicare PIN
WAAO4253Medicare UPIN