MEDICARE: SUK CHOO CHANG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MD00054884	WA

General Provider Information

NPI Number	:	1144248329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUK CHOO CHANG MD

Provider Business Mailing Address
First Line	:	2821 MISSION HILL RD
Second Line	:
City	:	TULALIP
State	:	WA
Zip	:	98271-9706
Country	:	US
Telephone Number	:	360-716-4400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2821 MISSION HILL ROAD
Second Line	:
City	:	TULALIP
State	:	WA
Zip	:	98271
Country	:	US
Telephone Number	:	360-716-4400
Fax Number	:	360-651-4404

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/14/2008

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Directions to “ SUK CHOO CHANG MD” Practice Location

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