Healthcare Provider Details

I. General information

NPI: 1215066592
Provider Name (Legal Business Name): HONG TD NGUYEN PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HONG TD NGUYEN PHARMACIST

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2921 NACHES AVE SW
RENTON WA
98057-2617
US

IV. Provider business mailing address

PO BOX 34383
SEATTLE WA
98124-1383
US

V. Phone/Fax

Practice location:
  • Phone: 206-630-7979
  • Fax: 206-630-7950
Mailing address:
  • Phone: 206-630-7979
  • Fax: 206-630-7950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00018979W
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: