Provider Demographics
NPI:1881746931
Name:CHEN, LI-JUAN
Entity type:Individual
Prefix:
First Name:LI-JUAN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1292 PINE CREST CIR NE
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-7469
Mailing Address - Country:US
Mailing Address - Phone:425-442-7297
Mailing Address - Fax:425-391-6909
Practice Address - Street 1:450 NW GILMAN BLVD
Practice Address - Street 2:SUITE 305
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2483
Practice Address - Country:US
Practice Address - Phone:425-442-7297
Practice Address - Fax:425-391-6909
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2016-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602102837171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist