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General NPI Number Information
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NPI Number | 1306636741
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Entity Type | Organization
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Legal Business Name | CCM SPECIALTY CARE LLC
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 11/27/2025
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Provider Practice Location Address
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Address Line | 710 S 348TH ST STE B
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City | FEDERAL WAY
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State | WA
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Zip | 98003-7042
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Country | US
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Telephone | 425-276-1825
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Fax | 206-899-1299
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Provider Business Mailing Address
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Address Line | 710 S 348TH ST STE B
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City | FEDERAL WAY
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State | WA
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Zip | 98003-7042
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Country | US
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Telephone | 425-276-1825
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Fax | 206-899-1299
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. CHRISTOPHER CHENG
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Credential | MD
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Telephone | 425-276-1825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number |
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Taxonomy #3
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Taxonomy Code | 2080P0201X
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Taxonomy Name | Pediatric Allergy/Immunology Physician
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License Number |
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Taxonomy #4
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number |
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Taxonomy #5
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number |
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Taxonomy #6
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Taxonomy Code | 2080S0010X
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Taxonomy Name | Pediatric Sports Medicine Physician
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License Number |
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Taxonomy #7
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Taxonomy Code | 2080P0008X
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Taxonomy Name | Pediatric Neurodevelopmental Disabilities Physician
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License Number |
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Taxonomy #8
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Taxonomy Code | 2080S0012X
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Taxonomy Name | Pediatric Sleep Medicine Physician
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License Number |
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Taxonomy #9
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number |
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Taxonomy #10
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number |
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Taxonomy #11
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Taxonomy Code | 2080P0216X
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Taxonomy Name | Pediatric Rheumatology Physician
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License Number |
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Taxonomy #12
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number |
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Taxonomy #13
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Taxonomy Code | 2080B0002X
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Taxonomy Name | Pediatric Obesity Medicine Physician
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License Number |
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Taxonomy #14
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Taxonomy Code | 2080P1004X
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Taxonomy Name | Physician Nutrition Specialist (Pediatrics)
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License Number |
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Taxonomy #15
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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