Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DE00009239 | WA |
NPI | 1003908740 |
---|---|
Provider Name | Dr. Judy C Chen |
First Address | Redmond, WA 98052-3550 |
Second Address | Redmond, WA 98052-3550 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 08/07/2007 |