Provider Demographics
NPI:1629363783
Name:DUSIN, CHASE Q (LMP)
Entity Type:Individual
Prefix:
First Name:CHASE
Middle Name:Q
Last Name:DUSIN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3703 S EDMUNDS ST
Mailing Address - Street 2:#236
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-1728
Mailing Address - Country:US
Mailing Address - Phone:206-602-8150
Mailing Address - Fax:
Practice Address - Street 1:3703 S EDMUNDS ST
Practice Address - Street 2:#236
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-1728
Practice Address - Country:US
Practice Address - Phone:206-602-8150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018166225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist