Healthcare Provider Details

I. General information

NPI: 1942095500
Provider Name (Legal Business Name): CHI B NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 04/14/2025
Certification Date: 04/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 S OTHELLO ST
SEATTLE WA
98118-3510
US

IV. Provider business mailing address

PO BOX 3007
SEATTLE WA
98114-3007
US

V. Phone/Fax

Practice location:
  • Phone: 206-788-3500
  • Fax:
Mailing address:
  • Phone: 206-788-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH61564017
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: