MEDICARE: JUSTIN CHEN

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	PH61073116	WA

General Provider Information

NPI Number	:	1851055511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN CHEN

Provider Business Mailing Address
First Line	:	9212 N SIMPSON RD
Second Line	:
City	:	NEWMAN LAKE
State	:	WA
Zip	:	99025-9485
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4550 42ND AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98116-4225
Country	:	US
Telephone Number	:	206-923-6391
Fax Number	:

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

Provider Enumeration Date	:	10/28/2021
Last Update Date	:	06/12/2026

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Directions to “ JUSTIN CHEN ” Practice Location

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