Active NPI
Calvin Chang
- Physical Therapist
- Renton, WA
National Provider Identifier
1780248088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT60379845
- Practice address
- 400 S 43Rd St
Renton, WA 98055-5714 - Phone
- (425) 251-5165
- Fax
- (425) 656-4028
- NPI assigned
- Apr 23, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT60379845 | WA | Primary |
Addresses
Primary practice location
400 S 43Rd St
Renton, WA 98055-5714
Mailing address
3600 Lind Ave SW
Suite 100 Attn Credentialing
Renton, WA 98057
Phone (425) 228-3440
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT60379845 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555977600000",
"number": "1780248088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 LIND AVE SW",
"address_2": "SUITE 100 ATTN CREDENTIALING",
"city": "RENTON",
"state": "WA",
"postal_code": "98057",
"telephone_number": "425-228-3440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 S 43RD ST",
"city": "RENTON",
"state": "WA",
"postal_code": "980555714",
"telephone_number": "425-251-5165",
"fax_number": "425-656-4028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "CALVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-23",
"last_updated": "2019-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT60379845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.