Basic Information
| Provider Information | |||||||||
| NPI: | 1619158797 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HWANG | ||||||||
| FirstName: | SEON | ||||||||
| MiddleName: | NANCY | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 410 | ||||||||
| Address2: | |||||||||
| City: | NEAH BAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983570410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606452233 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 250 FORT STREET | ||||||||
| Address2: | |||||||||
| City: | NEAH BAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983570410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606452233 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2007 | ||||||||
| LastUpdateDate: | 11/17/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | PH00067546 | WA | Y | Pharmacy Service Providers | Pharmacist | 183500000X | 56246 | CA | N | Pharmacy Service Providers | Pharmacist |
No ID Information.