Provider Demographics
NPI:1407282742
Name:CHIN, MATTHEW M (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:M
Last Name:CHIN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10886 DIXON DRIVE SOUTH
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178
Mailing Address - Country:US
Mailing Address - Phone:206-772-3348
Mailing Address - Fax:
Practice Address - Street 1:10886 DIXON DR S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98178-2719
Practice Address - Country:US
Practice Address - Phone:206-772-3348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 60391204183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist