Provider Demographics
NPI:1861756470
Name:HUANG, FERNANDA V (MD)
Entity type:Individual
Prefix:
First Name:FERNANDA
Middle Name:V
Last Name:HUANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16463 BOONES FERRY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-4374
Mailing Address - Country:US
Mailing Address - Phone:503-635-1350
Mailing Address - Fax:503-635-8470
Practice Address - Street 1:16463 BOONES FERRY RD STE 100
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-4374
Practice Address - Country:US
Practice Address - Phone:503-635-1350
Practice Address - Fax:503-635-8470
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116025151207Q00000X
ORMD174932207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine