Provider Demographics
NPI:1558359356
Name:ALLCHIN, CAROL (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:
Last Name:ALLCHIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 GEORGIANA ST
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-3511
Mailing Address - Country:US
Mailing Address - Phone:360-457-4431
Mailing Address - Fax:360-457-7755
Practice Address - Street 1:819 GEORGIANA ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-3511
Practice Address - Country:US
Practice Address - Phone:360-457-4431
Practice Address - Fax:360-457-7755
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00031456207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB000173Medicare ID - Type Unspecified
WAC89225Medicare UPIN