Provider Demographics
NPI:1295962637
Name:HWANG, MICHELLE PAO HSUAN (RPH)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:PAO HSUAN
Last Name:HWANG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 77710
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-0710
Mailing Address - Country:US
Mailing Address - Phone:206-953-4065
Mailing Address - Fax:425-774-1998
Practice Address - Street 1:22515 HWY 99
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8373
Practice Address - Country:US
Practice Address - Phone:425-670-2667
Practice Address - Fax:425-774-1998
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60009008183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist