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General NPI Number Information
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NPI Number | 1518451970
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Entity Type | Individual
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Provider Name | ANDREW CHANG DO
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Gender | Male
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 415 N KILLINGSWORTH ST STE 103
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City | PORTLAND
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State | OR
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Zip | 97217-2440
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Country | US
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Telephone | 971-299-7548
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 86700
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City | PORTLAND
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State | OR
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Zip | 97286-0700
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO207327
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License Number State | OR
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