Healthcare Provider Details

I. General information

NPI: 1477800951
Provider Name (Legal Business Name): QUYEN LE DAO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2012
Last Update Date: 08/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3523 S CHICAGO ST
SEATTLE WA
98118-4030
US

IV. Provider business mailing address

3523 S CHICAGO ST
SEATTLE WA
98118-4030
US

V. Phone/Fax

Practice location:
  • Phone: 206-349-6338
  • Fax:
Mailing address:
  • Phone: 206-349-6338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60288751
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: