Provider Demographics
NPI:1811023757
Name:JASON C. CHEUNG, M.D., P.S.
Entity Type:Organization
Organization Name:JASON C. CHEUNG, M.D., P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:A
Authorized Official - Last Name:CATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-698-0600
Mailing Address - Street 1:9800 LEVIN RD NW
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-7849
Mailing Address - Country:US
Mailing Address - Phone:360-698-0600
Mailing Address - Fax:360-613-0222
Practice Address - Street 1:9800 LEVIN RD NW
Practice Address - Street 2:SUITE 208
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7849
Practice Address - Country:US
Practice Address - Phone:360-698-0600
Practice Address - Fax:360-613-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00036111207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8226763Medicaid
WAAB26198Medicare ID - Type UnspecifiedGROUP #