Healthcare Provider Details

I. General information

NPI: 1881492908
Provider Name (Legal Business Name): NGOC CAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 112TH AVE NE STE A101
BELLEVUE WA
98004-3782
US

IV. Provider business mailing address

1623 187TH AVE NE
BELLEVUE WA
98008-3337
US

V. Phone/Fax

Practice location:
  • Phone: 425-588-5234
  • Fax:
Mailing address:
  • Phone: 206-376-8843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00071578
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: