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NPI Code Detail

MEDICARE: LISZU CHUNG PHARM. D.

MEDICARE:   LISZU  CHUNG  PHARM. D.
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
1183500000XPharmacistPH00067102WA

General Provider Information

NPI Number : 1164779047
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISZU CHUNG PHARM. D.
Provider Business Mailing Address
First Line : 3925 236TH AVE NE
Second Line :
City : REDMOND
State : WA
Zip : 98053-8455
Country : US
Telephone Number : 425-836-8706
Fax Number : 425-836-8728
Provider Business Practice Location Address
First Line : 3925 236TH AVE NE
Second Line :
City : REDMOND
State : WA
Zip : 98053-8455
Country : US
Telephone Number : 425-836-8706
Fax Number : 425-836-8728
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2012
Last Update Date : 08/09/2012

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Directions to “ LISZU CHUNG PHARM. D.” Practice Location

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