Healthcare Provider Details

I. General information

NPI: 1922843069
Provider Name (Legal Business Name): JENNIFER MINJI CHEUNG DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2024
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 MADISON ST STE 500
SEATTLE WA
98104-1305
US

IV. Provider business mailing address

1229 MADISON ST STE 500
SEATTLE WA
98104-1305
US

V. Phone/Fax

Practice location:
  • Phone: 206-338-3331
  • Fax:
Mailing address:
  • Phone: 702-577-6020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61605660
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN61206542
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: