Provider Demographics
NPI:1205387321
Name:CHIANG, PEI WEN (PHD, FACMG)
Entity Type:Individual
Prefix:DR
First Name:PEI WEN
Middle Name:
Last Name:CHIANG
Suffix:
Gender:M
Credentials:PHD, FACMG
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:
Other - Last Name:CHIANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5150 SW 209TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97078-1086
Mailing Address - Country:US
Mailing Address - Phone:720-880-8329
Mailing Address - Fax:
Practice Address - Street 1:5150 SW 209TH AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97078-1086
Practice Address - Country:US
Practice Address - Phone:720-880-8329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2017-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2009022246ZG1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZG1000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGeneticist, Medical (PhD)