Healthcare Provider Details

I. General information

NPI: 1083201636
Provider Name (Legal Business Name): JERRY CHUN-HAN CHEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2020
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE
SEATTLE WA
98104-2420
US

IV. Provider business mailing address

325 9TH AVE
SEATTLE WA
98104-2499
US

V. Phone/Fax

Practice location:
  • Phone: 206-744-3000
  • Fax:
Mailing address:
  • Phone: 206-744-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberDOL.OL.70108432
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A25227
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: