Healthcare Provider Details

I. General information

NPI: 1982333530
Provider Name (Legal Business Name): PO HUA CHEN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 06/08/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 FREMONT AVE N STE 209
SEATTLE WA
98103-8753
US

IV. Provider business mailing address

3601 FREMONT AVE N STE 209
SEATTLE WA
98103-8753
US

V. Phone/Fax

Practice location:
  • Phone: 425-318-9561
  • Fax: 877-393-1378
Mailing address:
  • Phone: 425-318-9561
  • Fax: 877-393-1378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA61271095
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: