Healthcare Provider Details

I. General information

NPI: 1376894675
Provider Name (Legal Business Name): KAREN LEE CHUNG MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2012
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

612 N 45TH ST UNIT B
SEATTLE WA
98103-6405
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-2106
  • Fax: 206-987-3946
Mailing address:
  • Phone: 909-868-8847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number337907
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60853387
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: