MEDICARE: ERIC HUYNH PHARM. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	5302030582	MI

General Provider Information

NPI Number	:	1780769000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC HUYNH PHARM. D.

Provider Business Mailing Address
First Line	:	10328 SW RIDGEVIEW LN
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97219-6317
Country	:	US
Telephone Number	:	503-220-8262
Fax Number	:

Provider Business Practice Location Address
First Line	:	10328 SW RIDGEVIEW LN
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97219-6317
Country	:	US
Telephone Number	:	503-220-8262
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	12/09/2015

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