Healthcare Provider Details
I. General information
NPI: 1619066081
Provider Name (Legal Business Name): JOSEPH H. HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/12/2006
Last Update Date: 02/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
315 MARTIN LUTHER KING JR WAY
TACOMA WA
98405-4234
US
IV. Provider business mailing address
315 MARTIN LUTHER KING JR WAY
TACOMA WA
98405-4234
US
V. Phone/Fax
- Phone: 253-680-6016
- Fax:
- Phone: 253-680-6016
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD24729 |
| License Number State | OR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | MD60626598 |
| License Number State | WA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD60626598 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: