Healthcare Provider Details

I. General information

NPI: 1558645036
Provider Name (Legal Business Name): JOHN C.CHEN.M.D., P.S.,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2011
Last Update Date: 10/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8659 INVERNESS DR NE
SEATTLE WA
98115-3987
US

IV. Provider business mailing address

8659 INVERNESS DR NE
SEATTLE WA
98115-3987
US

V. Phone/Fax

Practice location:
  • Phone: 206-526-0991
  • Fax: 206-523-9383
Mailing address:
  • Phone: 206-526-0991
  • Fax: 206-523-9383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD 00035600
License Number StateWA

VIII. Authorized Official

Name: DR. JOHN C CHEN
Title or Position: PRESIDENT
Credential: M.D
Phone: 206-755-5833