Provider Demographics
NPI:1902039209
Name:MAI, HUYEN (WENDY) B (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HUYEN (WENDY)
Middle Name:B
Last Name:MAI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12215 SE POWELL BLVD
Mailing Address - Street 2:WALGREENS #4943
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-3429
Mailing Address - Country:US
Mailing Address - Phone:503-760-2855
Mailing Address - Fax:503-760-2959
Practice Address - Street 1:12215 SE POWELL BLVD
Practice Address - Street 2:WALGREENS #4943
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97236-3429
Practice Address - Country:US
Practice Address - Phone:503-760-2855
Practice Address - Fax:503-760-2959
Is Sole Proprietor?:No
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-10485183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist