Provider Demographics
NPI:1386102549
Name:FENGLING CHEN
Entity type:Organization
Organization Name:FENGLING CHEN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FENGLING
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:408-493-0608
Mailing Address - Street 1:4633 141ST CT SE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-3054
Mailing Address - Country:US
Mailing Address - Phone:408-493-0608
Mailing Address - Fax:
Practice Address - Street 1:410 BELLEVUE WAY SE STE 304
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6649
Practice Address - Country:US
Practice Address - Phone:408-493-0608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA18281OtherACUPUNCTURIST