Provider Demographics
NPI:1265490312
Name:CHEN, NAIXI NICK (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:NAIXI
Middle Name:NICK
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 SW 43RD ST STE 200
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-4803
Mailing Address - Country:US
Mailing Address - Phone:206-588-1722
Mailing Address - Fax:253-277-8413
Practice Address - Street 1:1412 SW 43RD ST STE 200
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-4803
Practice Address - Country:US
Practice Address - Phone:206-588-1722
Practice Address - Fax:253-277-8413
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00040607207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP00000463OtherMEDICARE RAILROAD NUMBER
WAP00000463OtherMEDICARE RAILROAD NUMBER
WAGAB28568Medicare PIN