Healthcare Provider Details

I. General information

NPI: 1114422656
Provider Name (Legal Business Name): PRISCILLA HUANG DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 9TH AVE
SEATTLE WA
98101-2756
US

IV. Provider business mailing address

1100 9TH AVE MAIL STOP B2-AN
SEATTLE WA
98101
US

V. Phone/Fax

Practice location:
  • Phone: 206-223-6980
  • Fax:
Mailing address:
  • Phone: 206-223-6980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberOP61405858
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: