Provider Demographics
NPI:1184733024
Name:CHOW, ROBERT K (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:K
Last Name:CHOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13512 AMBAUM BLVD SW # 100
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98146-3168
Mailing Address - Country:US
Mailing Address - Phone:206-324-7546
Mailing Address - Fax:206-324-7547
Practice Address - Street 1:13512 AMBAUM BLVD SW # 100
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98146-3168
Practice Address - Country:US
Practice Address - Phone:206-324-7546
Practice Address - Fax:206-324-7547
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037378207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1124262Medicaid
WA5354CHOtherBLUESHIELD REGENCE
WA912177610OtherCOMMERCIAL
WA912177610OtherCOMMERCIAL
WA5354CHOtherBLUESHIELD REGENCE