Individual provider Active NPI

Craig Martin Chang, PTA

  • Physical Therapy Assistant
  • Federal Way, WA
National Provider Identifier
1760760698
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P1 60106080 Issued in WA
Practice address
1010 S 336TH St
Ste 210
Federal Way, WA 98003-6385
Phone
(253) 835-8091
NPI assigned
Jul 26, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X P1 60106080 WA Primary

Addresses

Primary practice location

1010 S 336TH St
Ste 210
Federal Way, WA 98003-6385

Mailing address

629 SW 331St St
Federal Way, WA 98023-6173
Phone (206) 227-8504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P1 60106080WAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1760760698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 SW 331ST ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980236173",
            "telephone_number": "206-227-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S 336TH ST",
            "address_2": "STE 210",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036385",
            "telephone_number": "253-835-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "CRAIG",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-26",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P1 60106080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.