Healthcare Provider Details

I. General information

NPI: 1033896071
Provider Name (Legal Business Name): QUYNH'S PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 07/29/2023
Certification Date: 07/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 S MAIN ST STE 103
SEATTLE WA
98144-2089
US

IV. Provider business mailing address

11902 83RD AVE S
SEATTLE WA
98178-3874
US

V. Phone/Fax

Practice location:
  • Phone: 206-323-6003
  • Fax: 206-323-6552
Mailing address:
  • Phone: 206-323-6003
  • Fax: 206-323-6552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. THANH D NGUYEN
Title or Position: OWNER/PHARMACIST
Credential: RPH
Phone: 206-351-5414