Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD00049137 | WA |
N | 208600000X | Surgeon | MD00049137 | WA |
N | 2082S0105X | Plastic Hand Surgeon | MD00049137 | WA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD00049137 | WA |
NPI | 1700908019 |
---|---|
Provider Name | Edwin Yao-Yuan Chang |
First Address | Mount Vernon, WA 98274-4127 |
Second Address | Mount Vernon, WA 98274-4127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 19/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0261838 | LABOR & INDUSTRIES (01) | WA |
0261838 | VICTIM'S OF CRIM (01) | WA |
170090819 | (05) | WA |
P00840095 | MEDICARE RAILROAD (01) |