Healthcare Provider Details

I. General information

NPI: 1154594794
Provider Name (Legal Business Name): EDWIN Y CHANG MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2008
Last Update Date: 10/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 E ROWAN AVE STE 206
SPOKANE WA
99207-1240
US

IV. Provider business mailing address

235 E ROWAN AVE STE 206
SPOKANE WA
99207-1240
US

V. Phone/Fax

Practice location:
  • Phone: 509-484-1212
  • Fax: 509-484-1277
Mailing address:
  • Phone: 509-484-1212
  • Fax: 509-484-1277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. EDWIN Y CHANG
Title or Position: OWNER
Credential:
Phone: 509-484-1212