MEDICARE: DR. HUNG VAN TRUONG PHARMD

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	PH00039009	WA

General Provider Information

NPI Number	:	1245217538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HUNG VAN TRUONG PHARMD

Provider Business Mailing Address
First Line	:	2915 14TH AVE S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98144-5718
Country	:	US
Telephone Number	:	206-583-6011
Fax Number	:	206-223-7653

Provider Business Practice Location Address
First Line	:	925 SENECA ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98101-2742
Country	:	US
Telephone Number	:	206-583-6011
Fax Number	:	206-223-7653

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

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	03/13/2012

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