MEDICARE: CHANGHO YI MD

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
1	208VP0014X	Interventional Pain Medicine Physician	MD61616683	WA

General Provider Information

NPI Number	:	1619618998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANGHO YI MD

Provider Business Mailing Address
First Line	:	4029 NORTHWEST AVE STE 301
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98226-9077
Country	:	US
Telephone Number	:	253-983-9390
Fax Number	:

Provider Business Practice Location Address
First Line	:	11306 BRIDGEPORT WAY SW STE D
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-3037
Country	:	US
Telephone Number	:	253-983-9390
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2022
Last Update Date	:	03/19/2026

Similar Medicare Providers

1124009303 — KYONG HO KIM DO
Practice Location Address:

11306 BRIDGEPORT WAY SW , SUITE D
LAKEWOOD, WA
98499-3037

Practice Phone: 253-983-9390
Practice Fax: 253-983-0066

1356443923 — ROBERT LEO TESTA PA-C
Practice Location Address:

11306 BRIDGEPORT WAY SW STE D
LAKEWOOD, WA
98499-3037

Practice Phone: 253-983-9390
Practice Fax: 253-983-0066

1053431684 — SOUND PAIN ALLIANCE
Practice Location Address:

11306 BRIDGEPORT WAY SW , #D
LAKEWOOD, WA
98499-3037

Practice Phone: 253-983-9390
Practice Fax: 253-983-0066

1699114025 — DR. MATTHEW TIMOTHY MCEWAN D.O.
Practice Location Address:

11306 BRIDGEPORT WAY SW STE D
LAKEWOOD, WA
98499-3037

Practice Phone: 253-983-9390
Practice Fax:

1851719421 — DR. ANDREW KOOGLER M.D.
Practice Location Address:

11306 BRIDGEPORT WAY SW STE D
LAKEWOOD, WA
98499-3037

Practice Phone: 253-983-9390
Practice Fax: 360-733-8320

1013311679 — PAUL BRADLEY PA-C
Practice Location Address:

11306 BRIDGEPORT WAY SW , STE D
LAKEWOOD, WA
98499-3037

Practice Phone: 425-774-1538
Practice Fax:

Directions to “ CHANGHO YI MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.