Provider Demographics
NPI:1518268515
Name:CHA, EUN HEE
Entity Type:Individual
Prefix:MRS
First Name:EUN
Middle Name:HEE
Last Name:CHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10350 WILLARD WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2508
Mailing Address - Country:US
Mailing Address - Phone:703-273-1333
Mailing Address - Fax:703-591-5730
Practice Address - Street 1:10350 WILLARD WAY
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2508
Practice Address - Country:US
Practice Address - Phone:703-273-1333
Practice Address - Fax:703-591-5730
Is Sole Proprietor?:No
Enumeration Date:2010-11-06
Last Update Date:2010-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011885183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist