Provider Demographics
NPI:1801247812
Name:CHUI, CHERRY MAN KA
Entity type:Individual
Prefix:MS
First Name:CHERRY MAN KA
Middle Name:
Last Name:CHUI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 12TH AVE SOUTH
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144
Mailing Address - Country:US
Mailing Address - Phone:206-548-3114
Mailing Address - Fax:206-762-6355
Practice Address - Street 1:10521 MERIDIAN AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9509
Practice Address - Country:US
Practice Address - Phone:206-296-4990
Practice Address - Fax:206-205-5142
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2022-07-21
Deactivation Date:2017-02-08
Deactivation Code:
Reactivation Date:2017-03-09
Provider Licenses
StateLicense IDTaxonomies
WADE60755880122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program