Provider Demographics
NPI:1467604231
Name:CHAFFEE, NANCY HENDERSON (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:HENDERSON
Last Name:CHAFFEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:LEE
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:307 S 13TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4100
Mailing Address - Country:US
Mailing Address - Phone:360-848-8500
Mailing Address - Fax:360-419-3700
Practice Address - Street 1:307 S 13TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4100
Practice Address - Country:US
Practice Address - Phone:360-848-8500
Practice Address - Fax:360-419-3700
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-10
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30096207R00000X
WA25240207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E98703Medicare UPIN
AZE98703Medicare UPIN