Provider Demographics
NPI:1942493267
Name:CHANG, SENH KEVIN (DC)
Entity Type:Individual
Prefix:DR
First Name:SENH
Middle Name:KEVIN
Last Name:CHANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:10303 NE WEIDLER ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-3882
Mailing Address - Country:US
Mailing Address - Phone:503-255-0306
Mailing Address - Fax:503-257-1452
Practice Address - Street 1:10303 NE WEIDLER ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-3882
Practice Address - Country:US
Practice Address - Phone:503-255-0306
Practice Address - Fax:503-257-1452
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR71 3759111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor