Provider Demographics
NPI:1174610992
Name:KAO, CHING P (MD)
Entity type:Individual
Prefix:
First Name:CHING
Middle Name:P
Last Name:KAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 SUMNER AVE
Mailing Address - Street 2:# F
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-4602
Mailing Address - Country:US
Mailing Address - Phone:360-532-2340
Mailing Address - Fax:360-866-8173
Practice Address - Street 1:1812 SUMNER AVE
Practice Address - Street 2:# F
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-4602
Practice Address - Country:US
Practice Address - Phone:360-532-2340
Practice Address - Fax:360-866-8173
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00020050207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAA08241Medicare UPIN