Provider Demographics
NPI:1740717156
Name:CHANG, ANNA-CARMINA FRANCISCO
Entity type:Individual
Prefix:
First Name:ANNA-CARMINA
Middle Name:FRANCISCO
Last Name:CHANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6092 OSPREY CIR
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-8807
Mailing Address - Country:US
Mailing Address - Phone:206-473-9963
Mailing Address - Fax:
Practice Address - Street 1:701 5TH AVE STE 42
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-7097
Practice Address - Country:US
Practice Address - Phone:206-473-9963
Practice Address - Fax:360-415-5870
Is Sole Proprietor?:No
Enumeration Date:2017-05-16
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA605499531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical