Basic Information
Provider Information
NPI: 1871977272
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAPMAN
FirstName: DAWN
MiddleName: MARIE
NamePrefix: MISS
NameSuffix:  
Credential: SUDP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8212 S. MARCH POINT ROAD
Address2:  
City: ANACORTES
State: WA
PostalCode: 982218684
CountryCode: US
TelephoneNumber: 3605882800
FaxNumber: 3605882808
Practice Location
Address1: 8212 S. MARCH POINT ROAD
Address2:  
City: ANACORTES
State: WA
PostalCode: 982218684
CountryCode: US
TelephoneNumber: 3605882800
FaxNumber: 3605882808
Other Information
ProviderEnumerationDate: 07/15/2015
LastUpdateDate: 08/22/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400XCP60521908WAN Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
101YA0400XCP60778162WAY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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