Provider Demographics
NPI:1376669374
Name:CHEN, SHAO-CHIU (DMD)
Entity Type:Individual
Prefix:
First Name:SHAO-CHIU
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 NW 144TH CIR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-1710
Mailing Address - Country:US
Mailing Address - Phone:617-771-0918
Mailing Address - Fax:
Practice Address - Street 1:3075 SE CENTURY BLVD STE 109
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-8187
Practice Address - Country:US
Practice Address - Phone:503-644-4749
Practice Address - Fax:503-649-2286
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA591961223X0400X
ORD101631223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics