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General NPI Number Information
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NPI Number | 1255046884
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Entity Type | Individual
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Provider Name | MY PHUONG VU
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Gender | Female
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Dates
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Enumeration Date | 01/18/2023
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Last Update Date | 04/08/2024
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Provider Practice Location Address
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Address Line | 19507 HIGHWAY 99
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City | LYNNWOOD
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State | WA
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Zip | 98036-5236
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Country | US
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Telephone | 425-640-0646
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Fax |
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Provider Business Mailing Address
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Address Line | 27 115TH ST SE
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City | EVERETT
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State | WA
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Zip | 98208-4942
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH61186275
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License Number State | WA
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