Healthcare Provider Details

I. General information

NPI: 1013587450
Provider Name (Legal Business Name): KAREN HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 06/28/2021
Certification Date: 06/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 S 19TH ST
RENTON WA
98055-4254
US

IV. Provider business mailing address

526 S 19TH ST
RENTON WA
98055-4254
US

V. Phone/Fax

Practice location:
  • Phone: 206-331-8053
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60986835
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: