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General NPI Number Information
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NPI Number | 1730432212
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Entity Type | Individual
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Provider Name | NHAT TA
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Gender | Male
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Dates
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Enumeration Date | 10/20/2012
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Last Update Date | 10/20/2012
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Provider Practice Location Address
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Address Line | 1701 AUBURN WAY S
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City | AUBURN
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State | WA
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Zip | 98002-6348
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Country | US
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Telephone | 253-394-0029
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 SW CAMPUS DR APT. 2-2
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City | FEDERAL WAY
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State | WA
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Zip | 98023-5363
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Country | US
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Telephone | 607-621-8311
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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 | PH60291782
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License Number State | WA
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