Healthcare Provider Details

I. General information

NPI: 1518335280
Provider Name (Legal Business Name): AMIA HUANG PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2015
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 NW 167TH PL # 100-42
BEAVERTON OR
97006-4908
US

IV. Provider business mailing address

1975 NW 167TH PL # 100-42
BEAVERTON OR
97006-4908
US

V. Phone/Fax

Practice location:
  • Phone: 562-340-6068
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number3276
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3276
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: