Healthcare Provider Details

I. General information

NPI: 1407177850
Provider Name (Legal Business Name): HENRY CHAU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 06/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 SW 148TH ST
BURIEN WA
98166-1924
US

IV. Provider business mailing address

4523 S 217TH ST
KENT WA
98032-1859
US

V. Phone/Fax

Practice location:
  • Phone: 206-835-0166
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number00039690
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: