Healthcare Provider Details

I. General information

NPI: 1235498692
Provider Name (Legal Business Name): CYNTHIA CHEN-CARMODY PTCB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2012
Last Update Date: 05/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11919 NE 8TH ST
BELLEVUE WA
98005-3023
US

IV. Provider business mailing address

20418 26TH AVE W
LYNNWOOD WA
98036-6966
US

V. Phone/Fax

Practice location:
  • Phone: 425-454-0146
  • Fax: 425-454-2980
Mailing address:
  • Phone: 425-454-0146
  • Fax: 425-454-2980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberVB00062026
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: