Provider Demographics
NPI:1174527121
Name:CH'EN, IAN YEN (MD)
Entity type:Individual
Prefix:DR
First Name:IAN
Middle Name:YEN
Last Name:CH'EN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19020 33RD AVE W STE 210
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4748
Mailing Address - Country:US
Mailing Address - Phone:425-563-1500
Mailing Address - Fax:425-563-1374
Practice Address - Street 1:19020 33RD AVE W STE 210
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036
Practice Address - Country:US
Practice Address - Phone:425-563-1500
Practice Address - Fax:425-563-1501
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA000528362085R0202X
IDM-124342085R0202X
WAMD000338692085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8198590Medicaid
WA220415OtherLNI PROVIDER ID
WA220412OtherLNI PROVIDER ID
WA682412Medicare PIN
WA8865202Medicare PIN
WA8868881Medicare PIN
WAP00434651Medicare PIN
ID20005244Medicare PIN
WA8865928Medicare PIN
WA220412OtherLNI PROVIDER ID
A06070Medicare UPIN
WAP00424272Medicare PIN
WAP00434271Medicare PIN
WA220415OtherLNI PROVIDER ID
WAP00601311Medicare PIN
WAG8904034Medicare PIN
WA8865929Medicare PIN