Provider Demographics
NPI:1689812661
Name:CHIANG, YI-JEN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:YI-JEN
Middle Name:
Last Name:CHIANG
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 108TH AVE NE STE 100
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-5508
Mailing Address - Country:US
Mailing Address - Phone:214-991-9445
Mailing Address - Fax:615-425-4271
Practice Address - Street 1:400 108TH AVE NE STE 100
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-5508
Practice Address - Country:US
Practice Address - Phone:425-635-6350
Practice Address - Fax:425-635-6351
Is Sole Proprietor?:No
Enumeration Date:2009-01-28
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60607267363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily