Provider Demographics
NPI:1790292142
Name:CHANG, KAREN SUNG (DAOM, LAC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:SUNG
Last Name:CHANG
Suffix:
Gender:F
Credentials:DAOM, LAC
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9801 DUPONT AVE S STE 408
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55431-3176
Mailing Address - Country:US
Mailing Address - Phone:952-378-7092
Mailing Address - Fax:
Practice Address - Street 1:15200 SHADY GROVE RD STE 103
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3218
Practice Address - Country:US
Practice Address - Phone:952-378-7092
Practice Address - Fax:240-901-4515
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-08
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02886171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist