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General NPI Number Information
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NPI Number | 1568980993
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Entity Type | Individual
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Provider Name | DIEM HONG T NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 09/06/2017
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Last Update Date | 09/06/2017
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Provider Practice Location Address
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Address Line | 1121 124TH AVE NE
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City | BELLEVUE
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State | WA
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Zip | 98005-2101
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Country | US
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Telephone | 206-243-2796
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Fax |
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Provider Business Mailing Address
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Address Line | 135 SW 114TH ST
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City | SEATTLE
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State | WA
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Zip | 98146-2353
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Country | US
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Telephone | 206-422-3524
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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 | PH60762961
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License Number State | WA
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