Provider Demographics
NPI:1336602473
Name:CHINN GYN LLC
Entity Type:Organization
Organization Name:CHINN GYN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHINN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:360-824-5278
Mailing Address - Street 1:PO BOX 1407
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-1407
Mailing Address - Country:US
Mailing Address - Phone:360-824-5278
Mailing Address - Fax:888-281-2979
Practice Address - Street 1:111 S 12TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4000
Practice Address - Country:US
Practice Address - Phone:360-824-5278
Practice Address - Fax:360-768-3134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-06
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive SurgeryGroup - Multi-Specialty
No261QA0006XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Fertility Facility
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
604425952OtherUBI