Provider Demographics
NPI:1669035044
Name:HOANG, CRYSTAL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:
Last Name:HOANG
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 1:21365 SW BALER WAY
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-8989
Mailing Address - Country:US
Mailing Address - Phone:503-610-6001
Mailing Address - Fax:503-610-9195
Practice Address - Street 1:21365 SW BALER WAY
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-8989
Practice Address - Country:US
Practice Address - Phone:503-610-6001
Practice Address - Fax:503-610-9195
Is Sole Proprietor?:No
Enumeration Date:2019-04-21
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77949183500000X
OR16844183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist