Healthcare Provider Details

I. General information

NPI: 1730365560
Provider Name (Legal Business Name): ZHANKUN CHENG PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2008
Last Update Date: 05/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9409 B 35TH AVE SW
SEATTLE WA
98126
US

IV. Provider business mailing address

9409 B 35TH AVE SW
SEATTLE WA
98126
US

V. Phone/Fax

Practice location:
  • Phone: 206-639-8535
  • Fax:
Mailing address:
  • Phone: 206-639-8535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBA60772921
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: