Healthcare Provider Details

I. General information

NPI: 1043570674
Provider Name (Legal Business Name): XI CHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2012
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9836 NE 29TH ST
BELLEVUE WA
98004-1805
US

IV. Provider business mailing address

9836 NE 29TH ST
BELLEVUE WA
98004-1805
US

V. Phone/Fax

Practice location:
  • Phone: 857-205-9806
  • Fax:
Mailing address:
  • Phone: 425-250-9011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMD60630605
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberMD60630605
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: