Provider Demographics
NPI:1184707515
Name:YEN, PEICHEN (LAC, DIPL OM)
Entity type:Individual
Prefix:
First Name:PEICHEN
Middle Name:
Last Name:YEN
Suffix:
Gender:M
Credentials:LAC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14106 ROBERT PARIS CT
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-4205
Mailing Address - Country:US
Mailing Address - Phone:703-595-2199
Mailing Address - Fax:703-595-2198
Practice Address - Street 1:14106 ROBERT PARIS CT
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-4205
Practice Address - Country:US
Practice Address - Phone:703-595-2199
Practice Address - Fax:703-595-2198
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121-000742171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist