Provider Demographics
NPI:1275743361
Name:CHEN, CHRISITNE SHIH-YIN (DDS)
Entity Type:Individual
Prefix:
First Name:CHRISITNE
Middle Name:SHIH-YIN
Last Name:CHEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13003 SE KENT KANGLEY RD
Mailing Address - Street 2:SUITE #109
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-7919
Mailing Address - Country:US
Mailing Address - Phone:253-630-8686
Mailing Address - Fax:253-630-0188
Practice Address - Street 1:13003 SE KENT KANGLEY RD
Practice Address - Street 2:SUITE #109
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-7919
Practice Address - Country:US
Practice Address - Phone:253-630-8686
Practice Address - Fax:253-630-0188
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA90771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice