Provider Demographics
NPI:1114946555
Name:HUANG, AGNES S (MD)
Entity Type:Individual
Prefix:
First Name:AGNES
Middle Name:S
Last Name:HUANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 MADISON ST
Mailing Address - Street 2:STE 1415
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3588
Mailing Address - Country:US
Mailing Address - Phone:206-328-7614
Mailing Address - Fax:206-328-6280
Practice Address - Street 1:1221 MADISON ST
Practice Address - Street 2:STE 1415
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3588
Practice Address - Country:US
Practice Address - Phone:206-328-7614
Practice Address - Fax:206-328-6280
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037570207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8242869Medicaid
WA0222343OtherL&I
WA8779HUOtherREGENCE
WA8779HUOtherREGENCE
F84293Medicare UPIN
WA8242869Medicaid