Healthcare Provider Details

I. General information

NPI: 1134168768
Provider Name (Legal Business Name): ANTHONY LUNG-TUNG CHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 S OTHELLO ST 2ND FLOOR
SEATTLE WA
98118-3510
US

IV. Provider business mailing address

6173 156TH PL SE
BELLEVUE WA
98006-5309
US

V. Phone/Fax

Practice location:
  • Phone: 206-461-4948
  • Fax:
Mailing address:
  • Phone: 206-850-1121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number30694
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: