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General NPI Number Information
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NPI Number | 1154013621
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Entity Type | Individual
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Provider Name | SHEROLYN CHANG PTA
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Gender | Female
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Dates
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Enumeration Date | 05/23/2023
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Last Update Date | 05/23/2023
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Provider Practice Location Address
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Address Line | 12391 SW MILLVIEW CT
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City | TIGARD
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State | OR
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Zip | 97223-3514
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Country | US
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Telephone | 808-728-5481
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Fax |
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Provider Business Mailing Address
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Address Line | 12391 SW MILLVIEW CT
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City | TIGARD
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State | OR
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Zip | 97223-3514
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Country | US
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Telephone | 808-728-5481
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 8764
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | CP017930A
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A-1071
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | CP014925A
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License Number State | CO
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Taxonomy #5
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 9848
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License Number State | OR
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