Healthcare Provider Details

I. General information

NPI: 1295559086
Provider Name (Legal Business Name): MIN CHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2024
Last Update Date: 11/09/2024
Certification Date: 11/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22421 6TH PL W
BOTHELL WA
98021-9705
US

IV. Provider business mailing address

22421 6TH PL W
BOTHELL WA
98021-9705
US

V. Phone/Fax

Practice location:
  • Phone: 425-540-8530
  • Fax:
Mailing address:
  • Phone: 425-540-8530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number61227748
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: