Individual
GINA CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1675 SW MARLOW AVE STE 200, PORTLAND, OR 97225-5102
(971) 248-2395
Mailing address
13840 SE RAMONA ST, PORTLAND, OR 97236-4451
(503) 915-1064
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/26/2019
Last updated
12/02/2019
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