Basic Information
Provider Information
NPI: 1801909692
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWN-CHANG
FirstName: JANELLE
MiddleName: V
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 34888
Address2:  
City: SEATTLE
State: WA
PostalCode: 981241888
CountryCode: US
TelephoneNumber: 4259774620
FaxNumber: 4257459836
Practice Location
Address1: 11800 NE 128TH ST
Address2: SUITE 100
City: KIRKLAND
State: WA
PostalCode: 980347208
CountryCode: US
TelephoneNumber: 4258994500
FaxNumber: 4258994510
Other Information
ProviderEnumerationDate: 08/16/2006
LastUpdateDate: 03/17/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100XMD00044304WAY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

ID Information
IDTypeStateIssuerDescription
103171605WA MEDICAID
025679901WALABOR AND INDUSTRIESOTHER


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