Healthcare Provider Details

I. General information

NPI: 1184147126
Provider Name (Legal Business Name): ERICA JULIE CHANG-PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2017
Last Update Date: 07/02/2023
Certification Date: 07/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14406 NE 20TH AVE
VANCOUVER WA
98686-1448
US

IV. Provider business mailing address

19875 SW 65TH AVE STE 250
TUALATIN OR
97062-8353
US

V. Phone/Fax

Practice location:
  • Phone: 800-813-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA151077
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: