Healthcare Provider Details

I. General information

NPI: 1184428732
Provider Name (Legal Business Name): NGAN NGOC KIM HUYNH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 100TH ST SW STE 100
LAKEWOOD WA
98499-2708
US

IV. Provider business mailing address

4716 E K ST
TACOMA WA
98404-2822
US

V. Phone/Fax

Practice location:
  • Phone: 253-588-3666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH61570995
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: