Provider Demographics
NPI:1669472908
Name:CHIN, PAMELA J (OD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:CHIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 25TH AVE NE STE 10
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3225
Mailing Address - Country:US
Mailing Address - Phone:206-432-9051
Mailing Address - Fax:206-432-9264
Practice Address - Street 1:5101 25TH AVE NE STE 10
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3225
Practice Address - Country:US
Practice Address - Phone:206-432-9051
Practice Address - Fax:206-432-9264
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3931152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2029783Medicaid
WA0191124OtherLABOR AND INDUSTRIES
WA5786W0OtherREGENCE
WADF8532OtherRAILROAD MEDICARE GROUP
WAP00398448OtherRAILROAD MEDICARE INDIVIDUAL
WA5819440003Medicare NSC
WAG8894180Medicare PIN
WA5819440002Medicare NSC
WADF8532OtherRAILROAD MEDICARE GROUP
WA0191124OtherLABOR AND INDUSTRIES
WA2029783Medicaid