Provider Demographics
NPI:1811431414
Name:CHAO, CHRISTINA (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:CHAO
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:CHRISTINA
Other - Middle Name:CHAO
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:820 BLANCHARD ST UNIT 1406
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2655
Mailing Address - Country:US
Mailing Address - Phone:917-868-7381
Mailing Address - Fax:
Practice Address - Street 1:567 JOHN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-5042
Practice Address - Country:US
Practice Address - Phone:206-724-0188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-15
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE606951301223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics