Provider Demographics
NPI:1275799041
Name:CHAPMAN, PAUL R
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:R
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7610 W NOB HILL BLVD
Mailing Address - Street 2:151
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-1957
Mailing Address - Country:US
Mailing Address - Phone:509-307-1147
Mailing Address - Fax:
Practice Address - Street 1:7610 W NOB HILL BLVD
Practice Address - Street 2:151
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-1957
Practice Address - Country:US
Practice Address - Phone:509-307-1147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator