Provider Demographics
NPI:1558645036
Name:JOHN C.CHEN.M.D., P.S.,INC
Entity Type:Organization
Organization Name:JOHN C.CHEN.M.D., P.S.,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-755-5833
Mailing Address - Street 1:8659 INVERNESS DR NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-3987
Mailing Address - Country:US
Mailing Address - Phone:206-526-0991
Mailing Address - Fax:206-523-9383
Practice Address - Street 1:8659 INVERNESS DR NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-3987
Practice Address - Country:US
Practice Address - Phone:206-526-0991
Practice Address - Fax:206-523-9383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-03
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 00035600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty