# BAYBERRY CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942111901
- **Authorized official:** DR. ANDREW CHANG DO (PHYSICIAN OWNER)
- **Authorized official phone:** (619) 931-3333

## Contact information

- **Practice address:** 4115 N MISSISSIPPI AVE, PORTLAND, OR 97217-3130
- **Practice address phone:** (503) 749-5959
- **Practice address fax:** (503) 974-3959
- **Mailing address:** 4115 N MISSISSIPPI AVE, PORTLAND, OR 97217-3130
- **Mailing address phone:** (503) 749-5959
- **Mailing address fax:** (503) 974-3959

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/16/2026
- **Last updated:** 09/16/2026