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NPI Code Detail

MEDICARE: BILLY NGUYEN VAN

MEDICARE: BILLY NGUYEN VAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist61065802WA

General Provider Information

NPI Number : 1922613728
Entity Type Code : Individual
Provider Name (Legal Business Name) : BILLY NGUYEN VAN
Provider Business Mailing Address
First Line : 20510 121ST WAY SE
Second Line :
City : KENT
State : WA
Zip : 98031-4187
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 105 WASHINGTON AVE N
Second Line :
City : KENT
State : WA
Zip : 98032-4438
Country : US
Telephone Number : 253-373-0156
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2020
Last Update Date : 09/09/2020

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Directions to “ BILLY NGUYEN VAN ” Practice Location

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