Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD00037288 | WA |
NPI | 1023102118 |
---|---|
Provider Name | Dr. Henry S Chang |
First Address | Seattle, WA 98104-1172 |
Second Address | Edmonds, WA 98026-7512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 24/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8241366 | (05) | WA |
G53978 | (02) |