Provider Demographics
NPI:1366896664
Name:CHIN-SANG, TARA (LMP)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:CHIN-SANG
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 E HOWELL ST
Mailing Address - Street 2:UNIT E-106
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-6920
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:506 E HOWELL ST
Practice Address - Street 2:UNIT E-106
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-6920
Practice Address - Country:US
Practice Address - Phone:845-798-9770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60620385225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist