# CCM SPECIALTY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CCM SPECIALTY CARE LLC
- **Other names:** CCM Adolescent Medicine and Psychiatry
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790578557
- **Legal business name:** CCM SPECIALTY CARE LLC
- **Authorized official:** DR. CHRISTOPHER CHENG (MEDICAL DIRECTOR)
- **Authorized official phone:** (425) 276-1825

## Contact information

- **Practice address:** 1940 116TH AVE NE STE 200B, BELLEVUE, WA 98004-3097
- **Practice address phone:** (425) 276-1825
- **Practice address fax:** (855) 785-8770
- **Mailing address:** 710 S 348TH ST STE B, FEDERAL WAY, WA 98003-7042
- **Mailing address phone:** (425) 276-1825
- **Mailing address fax:** (855) 785-8770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103G00000X | Clinical Neuropsychologist | — | NULL | — |
| 103G00000X | Clinical Neuropsychologist | — | — | — |
| 133NN1002X | Nutrition Education Nutritionist | — | NULL | — |
| 133NN1002X | Nutrition Education Nutritionist | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | NULL | Yes |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | — | Yes |
| 2080B0002X | Pediatric Obesity Medicine Physician | — | NULL | — |
| 2080B0002X | Pediatric Obesity Medicine Physician | — | — | — |
| 2080C0008X | Child Abuse Pediatrics Physician | — | NULL | — |
| 2080C0008X | Child Abuse Pediatrics Physician | — | — | — |
| 2080P1004X | Physician Nutrition Specialist (Pediatrics) | — | NULL | — |
| 2080P1004X | Physician Nutrition Specialist (Pediatrics) | — | — | — |

## Other

- **Enumeration date:** 05/26/2025
- **Last updated:** 09/14/2026