Provider Demographics
NPI:1780098558
Name:CHASE, LAURA (DDS)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:CHASE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13344 1ST AVE NE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-3059
Mailing Address - Country:US
Mailing Address - Phone:206-781-2501
Mailing Address - Fax:206-708-7742
Practice Address - Street 1:13344 1ST AVE NE
Practice Address - Street 2:SUITE 202
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-3059
Practice Address - Country:US
Practice Address - Phone:206-781-2501
Practice Address - Fax:206-708-7742
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA7726122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist