Provider Demographics
NPI:1174228431
Name:WANG, HUI
Entity type:Individual
Prefix:
First Name:HUI
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 N BRUTSCHER ST STE 214
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-6094
Mailing Address - Country:US
Mailing Address - Phone:503-538-0100
Mailing Address - Fax:971-832-8270
Practice Address - Street 1:901 N BRUTSCHER ST STE 214
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-6094
Practice Address - Country:US
Practice Address - Phone:503-538-0100
Practice Address - Fax:971-832-8270
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLMT-22506225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist