Provider Demographics
NPI:1700887007
Name:CHINN, LAUREN LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:LEE
Last Name:CHINN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14251 AMBAUM BLVD SW # R
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-1421
Mailing Address - Country:US
Mailing Address - Phone:206-248-0502
Mailing Address - Fax:206-248-2260
Practice Address - Street 1:14251R AMBAUM BLVD SW
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-1421
Practice Address - Country:US
Practice Address - Phone:206-248-0502
Practice Address - Fax:206-248-2260
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2012-06-20
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
WACH00001295111N00000X
OR281331111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0015859OtherDEPARTMENT OF LABOR & IND
WA0015859OtherDEPARTMENT OF LABOR & IND
WAT01554Medicare UPIN