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General NPI Number Information
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NPI Number | 1295463537
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Entity Type | Individual
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Provider Name | KHOA DANG LE PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 08/14/2022
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 3333 WHEATON WAY
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City | BREMERTON
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State | WA
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Zip | 98310-3449
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Country | US
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Telephone | 360-782-0907
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Fax | 360-373-3423
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Provider Business Mailing Address
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Address Line | 3333 WHEATON WAY
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City | BREMERTON
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State | WA
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Zip | 98310-3449
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Country | US
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Telephone | 208-346-1636
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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 | PHRM.PH.61324612
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License Number State | WA
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