Provider Demographics
NPI:1871566539
Name:CHANG, YEE TIFFANY (MD)
Entity type:Individual
Prefix:DR
First Name:YEE
Middle Name:TIFFANY
Last Name:CHANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:10250 SW GREENBURG RD
Mailing Address - Street 2:SUITE 110 LINCOLN BUILDIG 4
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-5443
Mailing Address - Country:US
Mailing Address - Phone:503-244-4268
Mailing Address - Fax:503-244-4261
Practice Address - Street 1:10250 SW GREENBURG RD
Practice Address - Street 2:SUITE 110 LINCOLN BUILDIG 4
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-5443
Practice Address - Country:US
Practice Address - Phone:503-244-4268
Practice Address - Fax:503-244-4261
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD24039207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR286607OtherOMAP
OR286607OtherOMAP
H72137Medicare UPIN