Basic Information
| Provider Information | |||||||||
| NPI: | 1417503178 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAPIN | ||||||||
| FirstName: | JUSTIN | ||||||||
| MiddleName: | EDWARD | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3209 S 23RD ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984051602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2532725127 | ||||||||
| FaxNumber: | 2532720811 | ||||||||
| Practice Location | |||||||||
| Address1: | 11216 SUNRISE BLVD E STE 3-207 | ||||||||
| Address2: | |||||||||
| City: | PUYALLUP | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983748848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2537703700 | ||||||||
| FaxNumber: | 2534357019 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2019 | ||||||||
| LastUpdateDate: | 03/02/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.