Provider Demographics
NPI:1790992824
Name:CHATHAM, DAVID MICHAEL (MD, LAC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MICHAEL
Last Name:CHATHAM
Suffix:
Gender:M
Credentials:MD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14810 SE LAKE HILLS BLVD., SUITE A-2
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-5821
Mailing Address - Country:US
Mailing Address - Phone:425-985-4576
Mailing Address - Fax:425-373-1416
Practice Address - Street 1:14810 LAKE HILLS BLVD STE A-2
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-5821
Practice Address - Country:US
Practice Address - Phone:425-985-4576
Practice Address - Fax:425-373-1416
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA502171100000X
WA29819208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice