NPIMap

Organization Active NPI

Lily Jei-Ho Chang

  • Non-Pharmacy Dispensing Site
  • Kirkland, WA
National Provider Identifier
1043664436
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
NT60454183 Issued in WA
Legal business name
LILY JEI-HO CHANG
Practice address
12710 102ND Ave NE
Kirkland, WA 98034-2847
Phone
(425) 286-7018
Fax
(888) 431-8819
NPI assigned
Apr 21, 2016
Organization subpart
Yes
Parent organization
LILY JEI-HO CHANGAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lily Jei-Ho Chang, N.D.
Title
Owner
Phone
(425) 286-7018

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X NT60454183 WA Primary

Addresses

Primary practice location

12710 102ND Ave NE
Kirkland, WA 98034-2847

Mailing address

2980 N Beverly Glen Cir
Suite 100
Los Angeles, CA 90077-1726
Phone (310) 943-4180

Other names 1

  • E-Tao Integrative Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lily Jei-Ho Chang2 organizations share this tax ID, including this one
Part of
Lily Jei-Ho Chang

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461196800000",
    "number": "1043664436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "SUITE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771726",
            "telephone_number": "310-943-4180",
            "fax_number": "888-431-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12710 102ND AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980342847",
            "telephone_number": "425-286-7018",
            "fax_number": "888-431-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILY JEI-HO CHANG",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LILY JEI-HO CHANG",
        "enumeration_date": "2016-04-21",
        "last_updated": "2016-04-21",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "LILY",
        "authorized_official_middle_name": "JEI-HO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-286-7018",
        "authorized_official_credential": "N.D."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "WA",
            "license": "NT60454183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "E-Tao Integrative Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.