Healthcare Provider Details

I. General information

NPI: 1275455099
Provider Name (Legal Business Name): TIANRONG MCDU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ZOE MCDU RPH

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17801 108TH AVE SE
RENTON WA
98055-6423
US

IV. Provider business mailing address

915 30TH AVE S
SEATTLE WA
98144-3206
US

V. Phone/Fax

Practice location:
  • Phone: 425-235-5383
  • Fax:
Mailing address:
  • Phone: 206-557-0152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPHRM.PH.70030679
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: