Provider Demographics
NPI:1952073447
Name:CHEN, MARINA LILY (DPT)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:LILY
Last Name:CHEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4455 INTERLAKE AVE N UNIT 431
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-7591
Mailing Address - Country:US
Mailing Address - Phone:507-573-2164
Mailing Address - Fax:
Practice Address - Street 1:5025 25TH AVE NE STE 201
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4152
Practice Address - Country:US
Practice Address - Phone:206-524-6702
Practice Address - Fax:206-524-6703
Is Sole Proprietor?:No
Enumeration Date:2021-10-02
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT611475252251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic