Healthcare Provider Details

I. General information

NPI: 1861503807
Provider Name (Legal Business Name): MARIA C HUANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 BLACK HILLS LN SW STE B2
OLYMPIA WA
98502-8661
US

IV. Provider business mailing address

2442 SAPP RD SW
TUMWATER WA
98512-6238
US

V. Phone/Fax

Practice location:
  • Phone: 360-472-2772
  • Fax: 360-964-3661
Mailing address:
  • Phone: 360-529-2087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD60088271
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: