Provider Demographics
NPI:1316184492
Name:CHENG, BRENTON T (DC)
Entity Type:Individual
Prefix:DR
First Name:BRENTON
Middle Name:T
Last Name:CHENG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 115TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3002
Mailing Address - Country:US
Mailing Address - Phone:503-839-5683
Mailing Address - Fax:
Practice Address - Street 1:1823 115TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3002
Practice Address - Country:US
Practice Address - Phone:503-839-5683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2013-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3852111N00000X
WACH60326743111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor