Healthcare Provider Details

I. General information

NPI: 1730907585
Provider Name (Legal Business Name): TAMMY THANH NINH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 ROCKEFELLER AVE STE 150
EVERETT WA
98201-1676
US

IV. Provider business mailing address

1330 ROCKEFELLER AVE STE 150
EVERETT WA
98201-1676
US

V. Phone/Fax

Practice location:
  • Phone: 425-297-5220
  • Fax: 425-297-5221
Mailing address:
  • Phone: 425-297-5220
  • Fax: 425-297-5221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH61568211
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPH61568211
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: