Logan Chang

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN.RN.70141821 Issued in WA

Practice address

9108 Lakewood Dr SW
Lakewood, WA 98499-3949

Phone

(253) 581-6202

NPI assigned

Jul 17, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Zheng Yao Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mark D Nellermoe Professional Service Corporation

  • Podiatrist
  • University Place, WA
  • NPI 1194145094
  NPD (past)

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

{
    "created_epoch": "1752710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1558253245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9108 LAKEWOOD DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993949",
            "telephone_number": "253-581-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9108 LAKEWOOD DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993949",
            "telephone_number": "253-581-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "LOGAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-17",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN.RN.70141821",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP61568782",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ZHENG",
            "last_name": "YAO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alfred H Chan, M.D.
• Emma Chan
• Maggie Chan, DPT
• Ahyoung Chang
• Hui K Chang, RPH
• Sung Chang, RPH
• Doris Jennette Chapie
• Genora Chappell
• Dee Ann Charles, MA
• Michael C Charles, ARNP

• Registered Nurse in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.