Provider Demographics
NPI:1952721292
Name:PEREZ, CHEMIN (LM)
Entity Type:Individual
Prefix:MS
First Name:CHEMIN
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 W BELL ST
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-3756
Mailing Address - Country:US
Mailing Address - Phone:626-818-3391
Mailing Address - Fax:
Practice Address - Street 1:375 W BELL ST
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3756
Practice Address - Country:US
Practice Address - Phone:626-818-3391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-25
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM383176B00000X
WAMW61104173176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2174037Medicaid