Provider Demographics
NPI:1679689780
Name:CHEN, ZACHARY H (MD)
Entity Type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:H
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3624 ENSIGN RD NE
Mailing Address - Street 2:SUITE E
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5074
Mailing Address - Country:US
Mailing Address - Phone:360-413-8199
Mailing Address - Fax:360-413-8198
Practice Address - Street 1:3624 ENSIGN RD NE
Practice Address - Street 2:SUITE E
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5074
Practice Address - Country:US
Practice Address - Phone:360-413-8199
Practice Address - Fax:360-413-8198
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2017-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00023128207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1114453Medicaid
A06124Medicare UPIN
WAG8876405Medicare PIN