Individual
DR. WALLACE HAN JEN CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17930 TALBOT RD S, RENTON, WA 98055-6230
(425) 228-3187
(425) 228-7972
Mailing address
805 MADISON ST, SUITE 901, SEATTLE, WA 98104-1172
(206) 264-8100
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
MD00019791
WA
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
MD00019791
WA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
MD00019791
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18213
L&I
—
05
—
1896307
—
WA
Enumeration date
01/04/2007
Last updated
05/02/2016
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