Basic Information
| Provider Information | |||||||||
| NPI: | 1588690523 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHINN | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | CNP ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 900 STEVENS DR | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | RICHLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 993523535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5099462699 | ||||||||
| FaxNumber: | 5099462677 | ||||||||
| Practice Location | |||||||||
| Address1: | 900 STEVENS DR | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | RICHLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 993523509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5099462699 | ||||||||
| FaxNumber: | 5099462677 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2006 | ||||||||
| LastUpdateDate: | 01/27/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | AP30007037 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 9652355 | 05 | WA | MEDICAID | 8861598 | 01 | WA | MEDICARE | OTHER |