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General NPI Number Information
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NPI Number | 1528827086
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Entity Type | Individual
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Provider Name | SERINA L CHEN
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Gender | Female
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 10915 SE PETROVITSKY RD
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City | RENTON
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State | WA
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Zip | 98055-5679
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Country | US
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Telephone | 425-572-6021
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Fax |
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Provider Business Mailing Address
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Address Line | 18304 NW MONTREUX DR
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City | ISSAQUAH
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State | WA
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Zip | 98027-7853
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Country | US
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Telephone | 425-652-3988
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DENT.DE.70021058
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License Number State | WA
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