Healthcare Provider Details

I. General information

NPI: 1811760861
Provider Name (Legal Business Name): CHENCLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2023
Last Update Date: 06/14/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S 320TH ST
FEDERAL WAY WA
98003-4691
US

IV. Provider business mailing address

9836 NE 29TH ST
BELLEVUE WA
98004-1805
US

V. Phone/Fax

Practice location:
  • Phone: 425-250-9011
  • Fax: 425-250-9021
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: XI CHEN
Title or Position: DR/OWNER
Credential: MD
Phone: 857-205-9806