Individual
TINA ANN CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 341-0860
Mailing address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00036408
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110196643
RAIL ROAD MEDICARE
WA
05
—
1912083635
—
WA
01
—
4566
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
8246472
—
WA
01
—
MD0735W
ALASKA MEDICAID
WA
01
—
P01030991
MEDICARE RAILROAD
WA
Enumeration date
10/27/2006
Last updated
10/10/2013
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