Healthcare Provider Details

I. General information

NPI: 1023633187
Provider Name (Legal Business Name): HANG HOANG-NGUYEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2020
Last Update Date: 06/14/2020
Certification Date: 06/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 BROADWAY
SEATTLE WA
98122-4307
US

IV. Provider business mailing address

901 8TH AVE APT 601
SEATTLE WA
98104-4274
US

V. Phone/Fax

Practice location:
  • Phone: 206-215-3605
  • Fax:
Mailing address:
  • Phone: 64-079-8572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60774007
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: