Healthcare Provider Details

I. General information

NPI: 1831941426
Provider Name (Legal Business Name): ETHAN JO-YUE CHENG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2024
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE BOX 359702
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

325 9TH AVE BOX 359702
SEATTLE WA
98195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 206-744-2122
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD.MD.70149374
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: