Individual
DR. PETER H CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
300 N GRAHAM ST STE 250, PORTLAND, OR 97227-1666
(503) 280-3418
(503) 284-7885
Mailing address
PO BOX 821350, VANCOUVER, WA 98682-0030
(360) 687-5221
(360) 666-0466
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
DO26736
OR
2080P0202X
Pediatric Cardiology Physician
OP00002095
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1123090
MEDICAID
WA
05
—
213128
—
OR
Enumeration date
08/30/2006
Last updated
09/11/2024
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