Healthcare Provider Details

I. General information

NPI: 1578835088
Provider Name (Legal Business Name): JAY CHEN M.D., P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2012
Last Update Date: 01/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 BELMONT AVE E APT 203
SEATTLE WA
98102-4430
US

IV. Provider business mailing address

1029 BELMONT AVE E APT 203
SEATTLE WA
98102-4430
US

V. Phone/Fax

Practice location:
  • Phone: 310-613-7198
  • Fax:
Mailing address:
  • Phone: 310-613-7198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD00045653
License Number StateWA

VIII. Authorized Official

Name: JAY CHEN
Title or Position: PRESIDENT/PHYSICIAN
Credential: M.D.
Phone: 310-613-7198