Healthcare Provider Details

I. General information

NPI: 1134252976
Provider Name (Legal Business Name): THU-THAO THI LE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELANIE THU-THAO T. LE RPH

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date: 03/04/2009
Reactivation Date: 09/26/2012

III. Provider practice location address

120 106TH AVE NE
BELLEVUE WA
98004-5910
US

IV. Provider business mailing address

14715 ADMIRALTY WAY APT A8
LYNNWOOD WA
98087-5985
US

V. Phone/Fax

Practice location:
  • Phone: 206-200-7350
  • Fax: 866-372-9676
Mailing address:
  • Phone: 206-200-7350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00048935
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: