Individual
ELLEN H CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1775 THOMPSON RD, COOS BAY, OR 97420-2198
(541) 269-8111
Mailing address
PO BOX 59028, RENTON, WA 98058-2028
(425) 656-5415
(425) 793-7458
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01077302A
IN
207RC0000X
Cardiovascular Disease Physician
MC-0231
ID
207RC0000X
Cardiovascular Disease Physician
MD00047746
WA
207RC0000X
Cardiovascular Disease Physician
MD186722
OR
207RI0011X
Interventional Cardiology Physician
MC-0231
ID
207RI0011X
Interventional Cardiology Physician
MD00047746
WA
207RI0011X
Interventional Cardiology Physician
Primary
MED-PHYS-LIC-45806
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001041073
ANTHEM PROVIDER NUMBER
IN
01
—
0248026
L&I
WA
01
—
1015CH
REGENCE
WA
05
—
201379160
—
IN
05
—
8478695
—
WA
01
—
8951017
CRIME VICTIMS
WA
Enumeration date
06/07/2006
Last updated
03/24/2021
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