Provider Demographics
NPI:1932115789
Name:KANITHANON, RAPIN CHAI (MD)
Entity Type:Individual
Prefix:DR
First Name:RAPIN
Middle Name:CHAI
Last Name:KANITHANON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1225 CAMPBELL WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-3323
Mailing Address - Country:US
Mailing Address - Phone:360-377-1355
Mailing Address - Fax:253-552-1239
Practice Address - Street 1:1225 CAMPBELL WAY STE 201
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3323
Practice Address - Country:US
Practice Address - Phone:360-377-1355
Practice Address - Fax:253-552-1239
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00046268207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1022453Medicaid
WA8460586Medicaid
WAI66604Medicare UPIN