Healthcare Provider Details

I. General information

NPI: 1528348075
Provider Name (Legal Business Name): DANIEL CHO PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2011
Last Update Date: 06/09/2023
Certification Date: 06/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 ROOSEVELT AVE
ENUMCLAW WA
98022-8246
US

IV. Provider business mailing address

152 ROOSEVELT AVE
ENUMCLAW WA
98022-8246
US

V. Phone/Fax

Practice location:
  • Phone: 360-802-1534
  • Fax:
Mailing address:
  • Phone: 360-802-1534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60320285
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: