Provider Demographics
NPI:1982091872
Name:CHAU, ALICE S (MD, MSE)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:S
Last Name:CHAU
Suffix:
Gender:F
Credentials:MD, MSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 9TH AVE # JMB-6
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1309
Mailing Address - Country:US
Mailing Address - Phone:068-847-1712
Mailing Address - Fax:204-985-3119
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-3816
Practice Address - Country:US
Practice Address - Phone:206-616-4840
Practice Address - Fax:206-616-4898
Is Sole Proprietor?:No
Enumeration Date:2015-04-19
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
WAMD61088892207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program