Provider Demographics
NPI:1386864940
Name:CHEN, YONG (LAC, LMT)
Entity type:Individual
Prefix:
First Name:YONG
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 DUKE ST
Mailing Address - Street 2:#423
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-2552
Mailing Address - Country:US
Mailing Address - Phone:703-461-7109
Mailing Address - Fax:703-461-7331
Practice Address - Street 1:4600 DUKE ST
Practice Address - Street 2:#423
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-2552
Practice Address - Country:US
Practice Address - Phone:703-461-7109
Practice Address - Fax:703-461-7331
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000210171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist