Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | DE60293192 | WA |
NPI | 1326303298 |
---|---|
Provider Name | Dr. Julia Yu Fong Chang |
First Address | Seattle, WA 98195-7133 |
Second Address | Seattle, WA 98195-7133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2012 |
Last Update Date | 11/10/2012 |