Provider Demographics
NPI:1609201276
Name:CHANG, CHENG-HUAN (RPH)
Entity Type:Individual
Prefix:
First Name:CHENG-HUAN
Middle Name:
Last Name:CHANG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22740 OLD POPLAR WAY
Mailing Address - Street 2:
Mailing Address - City:BRIER
Mailing Address - State:WA
Mailing Address - Zip Code:98036-8125
Mailing Address - Country:US
Mailing Address - Phone:206-251-7067
Mailing Address - Fax:
Practice Address - Street 1:22740 OLD POPLAR WAY
Practice Address - Street 2:
Practice Address - City:BRIER
Practice Address - State:WA
Practice Address - Zip Code:98036-8125
Practice Address - Country:US
Practice Address - Phone:206-251-7067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00056410183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist