Provider Demographics
NPI:1609049295
Name:CHEN, BENJAMIN Y (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:Y
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 5TH ST SE STE 4200
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-4604
Mailing Address - Country:US
Mailing Address - Phone:253-697-3450
Mailing Address - Fax:
Practice Address - Street 1:1450 5TH ST SE STE 4200
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-4604
Practice Address - Country:US
Practice Address - Phone:253-697-3450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110175207X00000X
WAMD60464425207XS0117X, 207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine