Provider Demographics
NPI:1427041102
Name:CHEN, JENNY (MD)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:955 POWELL AVE SW
Mailing Address - Street 2:SUITE A
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2908
Mailing Address - Country:US
Mailing Address - Phone:425-203-0452
Mailing Address - Fax:425-277-1566
Practice Address - Street 1:16315 NE 87TH ST
Practice Address - Street 2:STE B-6
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3537
Practice Address - Country:US
Practice Address - Phone:425-882-1697
Practice Address - Fax:425-885-4179
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00042290207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine