Provider Demographics
NPI:1669605309
Name:HUA, JENNIFER P (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:P
Last Name:HUA
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 1:20560 SW DOROTHY DR
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97006-2147
Mailing Address - Country:US
Mailing Address - Phone:503-433-4778
Mailing Address - Fax:
Practice Address - Street 1:14625 SW ALLEN BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-3600
Practice Address - Country:US
Practice Address - Phone:503-643-2724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0011387183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist