Provider Demographics
NPI:1043701642
Name:CHEN, YUANG (MBBS)
Entity Type:Individual
Prefix:
First Name:YUANG
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:YUANG
Other - Middle Name:
Other - Last Name:WEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:1708 YAKIMA AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-5300
Mailing Address - Country:US
Mailing Address - Phone:253-207-4850
Mailing Address - Fax:253-383-0161
Practice Address - Street 1:1708 YAKIMA AVE STE 107
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-5300
Practice Address - Country:US
Practice Address - Phone:253-207-4850
Practice Address - Fax:253-383-0161
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61426022207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2263274Medicaid