MEDICARE: LYDIA CHEN MOTR/L

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	225X00000X	Occupational Therapist	OT60469025	WA
2	163W00000X	Registered Nurse	RN61350483	WA
3	363LG0600X	Gerontology Nurse Practitioner	AP70015412	WA

General Provider Information

NPI Number	:	1316205669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYDIA CHEN MOTR/L

Provider Business Mailing Address
First Line	:	1959 NE PACIFIC ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98195-1001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1959 NE PACIFIC ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98195-8908
Country	:	US
Telephone Number	:	206-598-3300
Fax Number	:

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

Provider Enumeration Date	:	04/24/2012
Last Update Date	:	10/08/2025

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