Provider Demographics
NPI:1669602934
Name:HOPKINS, CHAD (LMP)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9414 RIDGETOP BLVD NW STE 103
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8526
Mailing Address - Country:US
Mailing Address - Phone:360-308-0250
Mailing Address - Fax:360-308-0195
Practice Address - Street 1:808 2ND AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1502
Practice Address - Country:US
Practice Address - Phone:206-453-2844
Practice Address - Fax:206-623-5529
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60049489225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist