Healthcare Provider Details

I. General information

NPI: 1831889997
Provider Name (Legal Business Name): PATRICK HUANG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 E JOHNSON AVE
COOS BAY OR
97420-1478
US

IV. Provider business mailing address

230 E JOHNSON AVE
COOS BAY OR
97420-1478
US

V. Phone/Fax

Practice location:
  • Phone: 541-267-1709
  • Fax:
Mailing address:
  • Phone: 541-267-1709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23593
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0020495
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: