Provider Demographics
NPI:1245328244
Name:HU, CHESTER CHI TAK (MD)
Entity type:Individual
Prefix:DR
First Name:CHESTER
Middle Name:CHI TAK
Last Name:HU
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 1:1615 DELAWARE ST
Mailing Address - Street 2:ANESTHESIOLOGY
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-2367
Mailing Address - Country:US
Mailing Address - Phone:360-636-4878
Mailing Address - Fax:360-414-7457
Practice Address - Street 1:1615 DELAWARE ST
Practice Address - Street 2:ANESTHESIOLOGY
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2367
Practice Address - Country:US
Practice Address - Phone:360-636-4878
Practice Address - Fax:360-414-7457
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8775207L00000X
WAMD00039238207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8504482Medicaid
OR279156Medicaid
WA8504482Medicaid
OR279156Medicaid
WAG8874212Medicare PIN
WAG8887816Medicare PIN