MEDICARE: KELVIN CHANG DPT

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	225100000X	Physical Therapist	65890	OR

General Provider Information

NPI Number	:	1720949225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELVIN CHANG DPT

Provider Business Mailing Address
First Line	:	17659 SW FALLING LEAF CT
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97003-7558
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16849 SW 65TH AVE
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97035-7865
Country	:	US
Telephone Number	:	503-598-8603
Fax Number	:

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

Provider Enumeration Date	:	11/24/2025
Last Update Date	:	11/24/2025

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Directions to “ KELVIN CHANG DPT” Practice Location

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