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General NPI Number Information
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NPI Number | 1396134383
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Entity Type | Individual
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Provider Name | SUJUAN CHEN
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Gender | Female
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Dates
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Enumeration Date | 01/14/2015
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Last Update Date | 01/14/2015
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Provider Practice Location Address
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Address Line | 3503 188TH ST SW
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City | LYNNWOOD
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State | WA
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Zip | 98037-4707
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Country | US
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Telephone | 425-220-3533
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Fax |
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Provider Business Mailing Address
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Address Line | 15201 ADMIRALTY WAY UNIT C9
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City | LYNNWOOD
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State | WA
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Zip | 98087-2437
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60526065
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License Number State | WA
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