Provider Demographics
NPI:1568803443
Name:BARAFF, CHELSEA NICOLE (DMD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:NICOLE
Last Name:BARAFF
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13510 NE 84TH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-3092
Mailing Address - Country:US
Mailing Address - Phone:360-696-0000
Mailing Address - Fax:
Practice Address - Street 1:13510 NE 84TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-3092
Practice Address - Country:US
Practice Address - Phone:360-696-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD9891122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist