Provider Demographics
NPI:1578782637
Name:CHEST MEDICINE CONSULTANTS, PS
Entity Type:Organization
Organization Name:CHEST MEDICINE CONSULTANTS, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABDEL-RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-347-5876
Mailing Address - Street 1:9809 NE 30TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-1840
Mailing Address - Country:US
Mailing Address - Phone:253-347-5876
Mailing Address - Fax:
Practice Address - Street 1:9809 NE 30TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-1840
Practice Address - Country:US
Practice Address - Phone:253-347-5876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00042646174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP00280329OtherRAILROAD MEDICARE
WA7128739Medicaid
WA=========OtherTAX ID NUMBER
WAG8855234Medicare PIN