Provider Demographics
NPI:1780980888
Name:CHIU, MICHELLE NMI (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:NMI
Last Name:CHIU
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:H
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2202 S CEDAR ST STE 100
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2318
Mailing Address - Country:US
Mailing Address - Phone:253-627-2900
Mailing Address - Fax:253-627-2941
Practice Address - Street 1:6401 KIMBALL DR STE 201
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1228
Practice Address - Country:US
Practice Address - Phone:253-853-8810
Practice Address - Fax:253-853-8820
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60169414363LA2200X, 363LF0000X
OR201050120NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500632568Medicaid
WA2011880Medicaid
WA2011880Medicaid
ORR159084Medicare PIN