Individual
CHONG C CHANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19875 SW 65TH AVE, SUITE 260, TUALATIN, OR 97062-8353
(503) 691-1743
(503) 691-0983
Mailing address
19875 SW 65TH AVE, SUITE 260, TUALATIN, OR 97062-8353
(503) 691-1743
(503) 691-0983
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD13588
OR
207VG0400X
Gynecology Physician
Primary
MD13588
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104752
—
OR
Enumeration date
03/12/2007
Last updated
03/04/2008
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