Basic Information
| Provider Information | |||||||||
| NPI: | 1982874970 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHEN | ||||||||
| FirstName: | XIAOMING | ||||||||
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| Credential: | MD, PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1535 | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984011535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2537614200 | ||||||||
| FaxNumber: | 2533833553 | ||||||||
| Practice Location | |||||||||
| Address1: | 1304 FAWCETT AVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984021911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2537614200 | ||||||||
| FaxNumber: | 2533833553 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2008 | ||||||||
| LastUpdateDate: | 08/10/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | MD00039001 | WA | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 8949628 | 01 | WA | LABOR AND INDUSTRIES CRIME VICTIMS-CAROL MILGARD BREAST CENTER | OTHER | 8951838 | 01 | WA | LABOR AND INDUSTRIES CRIME VICTIMS-MEDICAL IMAGING ON 1ST | OTHER | G8927632 | 01 | WA | PTAN-UAOM | OTHER | 0230293 | 01 | WA | LABOR AND INDUSTRIES-TRA | OTHER | 0249535 | 01 | WA | LABOR AND INDUSTRIES-MEDICAL IMAGING ON 1ST | OTHER | G8878589 | 01 | WA | PTAN-CMBC | OTHER | P00689880 | 01 | WA | RR MEDICARE-CAROL MILGARD BREAST CENTER | OTHER | 0243532 | 01 | WA | LABOR AND INDUSTRIES-CAROL MILGARD BREAST CENTER | OTHER | 8946791 | 01 | WA | LABOR AND INDUSTRIES CRIME VICTIMS-TRA | OTHER | 8871251 | 01 | WA | PTAN-TRA KING CO | OTHER | 8871252 | 01 | WA | PTAN-TRA PIERCE CO | OTHER | 8946794 | 01 | WA | LABOR AND INDUSTRIES CRIME VICTIMS-UNION AVENUE OPEN MRI | OTHER | 0230290 | 01 | WA | LABOR AND INDUSTRIES-UAOM | OTHER | G8882927 | 01 | WA | PTAN-MIO1 | OTHER |