Healthcare Provider Details

I. General information

NPI: 1780707083
Provider Name (Legal Business Name): WAYNE TIM LUK RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 WINSLOW WAY W
BAINBRIDGE ISLAND WA
98110-2512
US

IV. Provider business mailing address

124 WINSLOW WAY W
BAINBRIDGE ISLAND WA
98110-2512
US

V. Phone/Fax

Practice location:
  • Phone: 206-780-7809
  • Fax: 206-780-7801
Mailing address:
  • Phone: 206-780-7809
  • Fax: 206-842-7801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00042579
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: