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General NPI Number Information
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NPI Number | 1639798051
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Entity Type | Individual
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Provider Name | RAINA L CHANG DACM, LAC
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Gender | Female
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Dates
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Enumeration Date | 04/15/2020
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Last Update Date | 11/20/2020
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Provider Practice Location Address
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Address Line | 8390 W GAGE BLVD STE 113
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City | KENNEWICK
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State | WA
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Zip | 99336-8105
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Country | US
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Telephone | 509-378-7433
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Fax | 509-204-3363
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Provider Business Mailing Address
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Address Line | 8390 W GAGE BLVD STE 113
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City | KENNEWICK
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State | WA
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Zip | 99336-8105
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Country | US
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Telephone | 509-378-7433
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | ACU1289
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC60998031
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License Number State | WA
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