Provider Demographics
NPI:1376640631
Name:CHANGIZIAN, REBECCA (CST SAC)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:
Last Name:CHANGIZIAN
Suffix:
Gender:F
Credentials:CST SAC
Other - Prefix:
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Mailing Address - Street 1:5319 SW WESTGATE DR
Mailing Address - Street 2:SUITE 241
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97221-2432
Mailing Address - Country:US
Mailing Address - Phone:503-297-7223
Mailing Address - Fax:503-297-7603
Practice Address - Street 1:11782 SW BARNES RD
Practice Address - Street 2:SUITE 200
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225
Practice Address - Country:US
Practice Address - Phone:503-906-4300
Practice Address - Fax:503-906-4333
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist