Provider Demographics
NPI:1730428046
Name:CHANG, I-HSIN TAMMY (L AC)
Entity type:Individual
Prefix:
First Name:I-HSIN
Middle Name:TAMMY
Last Name:CHANG
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:L AC
Mailing Address - Street 1:2273 KINGS GARDEN WAY
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-2558
Mailing Address - Country:US
Mailing Address - Phone:571-426-2195
Mailing Address - Fax:
Practice Address - Street 1:2273 KINGS GARDEN WAY
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2558
Practice Address - Country:US
Practice Address - Phone:571-426-2195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000675171100000X
MDU01968171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist