| Doctor Name: | CHAD DOUGLAS FASHANT |
| NPI Number: | 1871701169 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.M.P. |
| License Number: | MA00017855 |
| Business Practice Address: | 1612 Sw Dash Point Rd Federal Way, WA - 980234530 |
| Business Phone Number: | 2538355678 |
| Business Fax Number: | 2538357342 |
| Mailing Address: | 17041 34th Ave S, SEATAC |
| State: | WA |
| Postal Code: | 981884449 |
| Phone Number: | 2062187648 |
| Fax Number: | |
| NPI Enumeration Date: | 05/18/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | MA00017855 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |