Healthcare Provider Details

I. General information

NPI: 1447046636
Provider Name (Legal Business Name): BILL HUANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3066 ISSAQUAH PINE LAKE RD SE
SAMMAMISH WA
98075-7253
US

IV. Provider business mailing address

21037 SE 5TH ST
SAMMAMISH WA
98074-7081
US

V. Phone/Fax

Practice location:
  • Phone: 425-391-1582
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH61652906
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: