Healthcare Provider Details

I. General information

NPI: 1265494751
Provider Name (Legal Business Name): ENOCH T HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 SE MAIN ST SUITE 9
PORTLAND OR
97216-2937
US

IV. Provider business mailing address

PO BOX 92900
PORTLAND OR
97292-0900
US

V. Phone/Fax

Practice location:
  • Phone: 503-252-4325
  • Fax: 503-261-6789
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD26230
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License NumberMD26230
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: