Provider Demographics
NPI:1124110614
Name:CHANG, ARIENE (DC)
Entity type:Individual
Prefix:DR
First Name:ARIENE
Middle Name:
Last Name:CHANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2694
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-2694
Mailing Address - Country:US
Mailing Address - Phone:425-224-5589
Mailing Address - Fax:
Practice Address - Street 1:4320 196TH ST SW STE A1
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6773
Practice Address - Country:US
Practice Address - Phone:425-224-5589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034133111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0171393OtherLABOR & INDUSTRIES
WA217421250709OtherPREMERA
WAU93729Medicare UPIN
WA0171393OtherLABOR & INDUSTRIES