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General NPI Number Information
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NPI Number | 1497414288
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Entity Type | Individual
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Provider Name | JANE CHANG
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Gender | Female
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Dates
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Enumeration Date | 12/09/2021
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 131 SW 156TH ST STE 200
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City | BURIEN
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State | WA
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Zip | 98166-2513
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Country | US
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Telephone | 206-246-3222
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Fax |
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Provider Business Mailing Address
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Address Line | 6236 54TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98115-7720
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Country | US
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Telephone | 267-992-0853
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 61271589
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License Number State | WA
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