Healthcare Provider Details

I. General information

NPI: 1003691387
Provider Name (Legal Business Name): CHARLIE HUYNH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 ROCKEFELLER AVE STE 150
EVERETT WA
98201-1676
US

IV. Provider business mailing address

1330 ROCKEFELLER AVE STE 150
EVERETT WA
98201-1676
US

V. Phone/Fax

Practice location:
  • Phone: 720-343-6546
  • Fax:
Mailing address:
  • Phone: 425-297-5220
  • Fax: 425-297-5220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number1835P2201X
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: