Healthcare Provider Details

I. General information

NPI: 1598130445
Provider Name (Legal Business Name): STEVEN HUANG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2015
Last Update Date: 12/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 MOUNTAIN VIEW DR
SHELTON WA
98584-4401
US

IV. Provider business mailing address

901 MOUNTAIN VIEW DR
SHELTON WA
98584-4401
US

V. Phone/Fax

Practice location:
  • Phone: 360-426-1611
  • Fax: 360-427-3617
Mailing address:
  • Phone: 360-426-1611
  • Fax: 360-427-3617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH60376897
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: