Healthcare Provider Details

I. General information

NPI: 1427422328
Provider Name (Legal Business Name): TUVY PHAM PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2015
Last Update Date: 11/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 S SNOQUALMIE ST
SEATTLE WA
98108-1968
US

IV. Provider business mailing address

400 S 43RD ST
RENTON WA
98055-5714
US

V. Phone/Fax

Practice location:
  • Phone: 206-371-1068
  • Fax:
Mailing address:
  • Phone: 425-228-3440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60343867
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: