MEDICARE: HUNG THANH LE RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PH39897	WA

General Provider Information

NPI Number	:	1043567373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUNG THANH LE RPH

Provider Business Mailing Address
First Line	:	14561 SE 154TH ST
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98058-8117
Country	:	US
Telephone Number	:	425-272-1908
Fax Number	:

Provider Business Practice Location Address
First Line	:	1605 S 93RD ST STE EB
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98108-5112
Country	:	US
Telephone Number	:	206-767-0411
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2012
Last Update Date	:	08/06/2012

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