Healthcare Provider Details

I. General information

NPI: 1972416832
Provider Name (Legal Business Name): SONG-KHANH-LINH TRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINH SONG-KHANH TRAN

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 124TH AVE NE
BELLEVUE WA
98005-2101
US

IV. Provider business mailing address

17202 15TH AVE NE
SHORELINE WA
98155-5130
US

V. Phone/Fax

Practice location:
  • Phone: 425-455-6444
  • Fax:
Mailing address:
  • Phone: 206-364-4618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHRM.PH.70153311
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: