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NPI Code Detail

MEDICARE: CHARLENE CHANG PA-C

MEDICARE: CHARLENE CHANG PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant
2363AS0400XSurgical Physician AssistantPA61541888WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1497750OTHERWAWA L&I
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235964644
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLENE CHANG PA-C
Provider Business Mailing Address
First Line : PO BOX 50095
Second Line :
City : SEATTLE
State : WA
Zip : 98145-5095
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 325 9TH AVE
Second Line :
City : SEATTLE
State : WA
Zip : 98104-2420
Country : US
Telephone Number : 206-520-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2024
Last Update Date : 05/06/2026

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Directions to “ CHARLENE CHANG PA-C” Practice Location

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