Provider Demographics
NPI:1346676814
Name:CHEN, VICTORIA (PH60389488)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:PH60389488
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:947 POWELL AVE SW STE 200
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2975
Mailing Address - Country:US
Mailing Address - Phone:877-233-0246
Mailing Address - Fax:
Practice Address - Street 1:947 POWELL AVE SW STE 100
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2975
Practice Address - Country:US
Practice Address - Phone:425-203-0416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60389488183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPH60389488OtherPHARMACIST LICENSE