Provider Demographics
NPI:1336416338
Name:HUANG, HARRY (RN)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4433 FOX HOLLOW RD
Mailing Address - Street 2:APT. #3
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-4571
Mailing Address - Country:US
Mailing Address - Phone:650-465-5661
Mailing Address - Fax:
Practice Address - Street 1:4433 FOX HOLLOW RD
Practice Address - Street 2:APT. #3
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-4571
Practice Address - Country:US
Practice Address - Phone:650-465-5661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-19
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201043114RN163W00000X
CA775795163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse