MEDICARE: DR. NAIXI NICK CHEN M.D., PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	MD00040607	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00000463	OTHER	WA	MEDICARE RAILROAD NUMBER

General Provider Information

NPI Number	:	1265490312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAIXI NICK CHEN M.D., PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 66596
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98166-0596
Country	:	US
Telephone Number	:	206-588-1722
Fax Number	:	253-277-8413

Provider Business Practice Location Address
First Line	:	1412 SW 43RD ST STE 200
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98057-4803
Country	:	US
Telephone Number	:	206-588-1722
Fax Number	:	253-277-8413

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	10/09/2024

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