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General NPI Number Information
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NPI Number | 1124793211
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Entity Type | Individual
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Provider Name | SUJAY CHANG
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Gender | Male
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Dates
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Enumeration Date | 08/11/2021
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 925 SENECA ST
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City | SEATTLE
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State | WA
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Zip | 98101-2742
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Country | US
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Telephone | 206-223-6877
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Fax |
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Provider Business Mailing Address
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Address Line | 1321 SENECA ST APT 1605
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City | SEATTLE
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State | WA
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Zip | 98101-3257
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH60670719
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License Number State | WA
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