Provider Demographics
NPI:1477720878
Name:CHEN, DANIEL SHAOHUA (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:SHAOHUA
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SHAOHUA
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 14001
Mailing Address - Street 2:SALEM
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97309
Mailing Address - Country:US
Mailing Address - Phone:503-561-5200
Mailing Address - Fax:
Practice Address - Street 1:875 OAK ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3975
Practice Address - Country:US
Practice Address - Phone:503-814-6387
Practice Address - Fax:503-814-8243
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4478982084N0400X
ORMD1692312084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500674731Medicaid
PA1027928260002Medicaid