Healthcare Provider Details

I. General information

NPI: 1326335506
Provider Name (Legal Business Name): WEIYAN HUANG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2011
Last Update Date: 07/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S 43RD ST
RENTON WA
98055-5714
US

IV. Provider business mailing address

603 ILWACO PL NE
RENTON WA
98059-4499
US

V. Phone/Fax

Practice location:
  • Phone: 425-228-3450
  • Fax:
Mailing address:
  • Phone: 509-240-4761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60219454
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: