Doctor Name: | LI CHANG |
NPI Number: | 1376627968 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 200250164NP |
Business Practice Address: | 2050 Progress Way Woodburn, OR - 970719764 |
Business Phone Number: | 5039815348 |
Business Fax Number: | 5039810423 |
Mailing Address: | 2050 Progress Way, WOODBURN |
State: | OR |
Postal Code: | 970719764 |
Phone Number: | 5039815348 |
Fax Number: | 5039810423 |
NPI Enumeration Date: | 10/24/2006 |
NPI Last Update Date: | 09/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 200250164NP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |