Provider Demographics
NPI:1699862466
Name:CHEN, JIE (OMD)
Entity type:Individual
Prefix:MS
First Name:JIE
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11120 NEW HAMPSHIRE AVE STE 409
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2620
Mailing Address - Country:US
Mailing Address - Phone:301-335-6155
Mailing Address - Fax:
Practice Address - Street 1:11120 NEW HAMPAHIRE AVE SUITE 409
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904
Practice Address - Country:US
Practice Address - Phone:301-335-6155
Practice Address - Fax:301-947-8097
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00564171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU00564OtherACUPUNCTURIST