Provider Demographics
NPI:1205634532
Name:CHEN, CHIHOUNG JONATHAN
Entity type:Individual
Prefix:
First Name:CHIHOUNG
Middle Name:JONATHAN
Last Name:CHEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13594 COBRA DR
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-4079
Mailing Address - Country:US
Mailing Address - Phone:703-462-0266
Mailing Address - Fax:703-462-0266
Practice Address - Street 1:800 S FREDERICK AVE STE 103
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-4154
Practice Address - Country:US
Practice Address - Phone:301-709-4551
Practice Address - Fax:301-990-1177
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02986171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist