Provider Demographics
NPI:1538244660
Name:MA, SHWEY-CHUN (DDS, DMD, MSD)
Entity type:Individual
Prefix:
First Name:SHWEY-CHUN
Middle Name:
Last Name:MA
Suffix:
Gender:F
Credentials:DDS, DMD, MSD
Other - Prefix:
Other - First Name:POLLY
Other - Middle Name:
Other - Last Name:MA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, DMD, MSD
Mailing Address - Street 1:3327 NE 125TH ST
Mailing Address - Street 2:STE. 102
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4587
Mailing Address - Country:US
Mailing Address - Phone:206-362-8314
Mailing Address - Fax:206-362-3028
Practice Address - Street 1:3327 NE 125TH ST
Practice Address - Street 2:STE. 102
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4587
Practice Address - Country:US
Practice Address - Phone:206-362-8314
Practice Address - Fax:206-362-3028
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA99201223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9920OtherDENTAL LICENSE #
WA603231461OtherUBI