Healthcare Provider Details

I. General information

NPI: 1336716794
Provider Name (Legal Business Name): DAVID CHEN WORTHINGTON PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2021
Last Update Date: 06/04/2021
Certification Date: 06/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S UNION AVE STE 7009
TACOMA WA
98405-1702
US

IV. Provider business mailing address

509 VALLEY AVE NE UNIT 4
PUYALLUP WA
98372-6965
US

V. Phone/Fax

Practice location:
  • Phone: 253-459-6746
  • Fax:
Mailing address:
  • Phone: 775-527-3442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPH61064531
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: