NPIMap

Individual provider Active NPI

Chia-Jen Kuan, M.D., PHD

  • Nephrology Physician
  • Mount Vernon, WA
National Provider Identifier
1114031655
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD00031127 Issued in WA
Practice address
1500 E Broadway
Mount Vernon, WA 98274-4523
Phone
(425) 257-1100
Fax
(251) 286-2102
NPI assigned
Aug 19, 2006
Last updated
Aug 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD00031127 WA Primary
Nephrology Physician 207RN0300X 175261 MT

Addresses

Primary practice location

1500 E Broadway
Mount Vernon, WA 98274-4523

Mailing address

1500 E Broadway
Mount Vernon, WA 98274-4523
Phone (425) 257-1100

Other practice location 1

22722 29th Dr SE
Bothell, WA 98021-4401
Phone (425) 257-1100

Other identifiers 2

IdentifierTypeStateIssuer
912171951OtherWATAX ID
1114883MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060316000015 WA Practitioner - NephrologyPractitioner - Internal Medicine 6709776271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
C J Kuan MD Inc PSGroup PAC ID 2365332830, 2 clinicians

Practice addresses (Care Compare)

1111 Pacific Ave
Suite 2
Everett, WA 98201-4200
Phone (425) 257-1100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
C J Kuan MD Inc PS Nephrology CurrentSince Mar 1, 2002 Accepting new patients

Locations

1111 Pacific Ave
Ste 2
Everett, WA 98201
Phone (360) 734-8204

1111 Pacific Ave
Ste B
Everett, WA 98201
Phone (425) 257-1100

121 S 12th St
Ste A
Mount Vernon, WA 98274
Phone (360) 982-2210

1500 E Broadway
Mount Vernon, WA 98274
Phone (360) 982-2210

Interoperability endpoints

  • Direct secure messaging: chia.kuan@direct.davitaphysiciansolutions.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1114031655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E BROADWAY",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744523",
            "telephone_number": "425-257-1100",
            "fax_number": "251-286-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E BROADWAY",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744523",
            "telephone_number": "425-257-1100",
            "fax_number": "251-286-2102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22722 29th Dr SE",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980214401",
            "country_code": "US",
            "telephone_number": "425-257-1100",
            "fax_number": "251-286-2102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUAN",
        "first_name": "CHIA-JEN",
        "credential": "M.D., PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD00031127",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MT",
            "license": "175261",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "912171951",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114883",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.