Provider Demographics
NPI:1760431126
Name:CHOW, JENNY SOU (MD)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:SOU
Last Name:CHOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 NW MYHRE RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8676
Mailing Address - Country:US
Mailing Address - Phone:360-782-3100
Mailing Address - Fax:
Practice Address - Street 1:1780 NW MYHRE RD STE 2120
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8676
Practice Address - Country:US
Practice Address - Phone:360-782-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037877208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
1238CHOtherREGENCE BLUE SHIELD
WA131996OtherLABOR & INDUSTRIES
370014751OtherRAILROAD MEDICARE
WA1018288Medicaid
7781011OtherAETNA
7781011OtherAETNA
7781011OtherAETNA
1238CHOtherREGENCE BLUE SHIELD
370014751OtherRAILROAD MEDICARE
BC6492300OtherDEA
WAGAB10666Medicare PIN
WAGAB10472Medicare PIN
WAGAB10668Medicare PIN
H00923Medicare UPIN
WAGAB10669Medicare PIN