| Doctor Name: | DR. JACOB PETERSEN CHAFFEE |
| NPI Number: | 1811983562 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | MD00042597 |
| Business Practice Address: | 411 Fortuyn Rd Coulee Community Hospital Grand Coulee, WA - 991338718 |
| Business Phone Number: | 5096331753 |
| Business Fax Number: | 5096331930 |
| Mailing Address: | 411 Fortuyn Rd, GRAND COULEE |
| State: | WA |
| Postal Code: | 991338718 |
| Phone Number: | 5096331911 |
| Fax Number: | 5096331933 |
| NPI Enumeration Date: | 09/27/2005 |
| NPI Last Update Date: | 09/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VX0000X |
| License Number: | MD00042597 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Obstetrics |
| Taxonomy Definition: | |