Healthcare Provider Details

I. General information

NPI: 1447284849
Provider Name (Legal Business Name): STANLEY JIAN CHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JIAN CHEN

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 07/06/2020
Certification Date: 07/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 116TH AVE NE STE 200
BELLEVUE WA
98004-3052
US

IV. Provider business mailing address

PO BOX 12362
MILL CREEK WA
98082-0362
US

V. Phone/Fax

Practice location:
  • Phone: 425-502-8075
  • Fax: 425-967-5810
Mailing address:
  • Phone: 908-392-3429
  • Fax: 425-967-5810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberND 8797
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberMD60088034
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: