Basic Information
| Provider Information | |||||||||
| NPI: | 1598130445 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUANG | ||||||||
| FirstName: | STEVEN | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 901 MOUNTAIN VIEW DR | ||||||||
| Address2: | |||||||||
| City: | SHELTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985844401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604261611 | ||||||||
| FaxNumber: | 3604273617 | ||||||||
| Practice Location | |||||||||
| Address1: | 901 MOUNTAIN VIEW DR | ||||||||
| Address2: | |||||||||
| City: | SHELTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985844401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604261611 | ||||||||
| FaxNumber: | 3604273617 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2015 | ||||||||
| LastUpdateDate: | 12/03/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P0018X | PH60376897 | WA | Y | Pharmacy Service Providers | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
No ID Information.