Provider Demographics
NPI:1396822896
Name:CHOU, AMENDA YEN-WEN (OD)
Entity Type:Individual
Prefix:DR
First Name:AMENDA
Middle Name:YEN-WEN
Last Name:CHOU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 148TH PL SE
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-9016
Mailing Address - Country:US
Mailing Address - Phone:253-709-0259
Mailing Address - Fax:
Practice Address - Street 1:820 148TH PL SE
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-9016
Practice Address - Country:US
Practice Address - Phone:253-709-0259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAWA3761TX152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAV07510Medicare UPIN