MEDICARE: VICKI NGUYEN

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	60799022	WA

General Provider Information

NPI Number	:	1295200376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICKI NGUYEN

Provider Business Mailing Address
First Line	:	14641 BROMLEY ST
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-5703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4130 E MADISON ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98112-3231
Country	:	US
Telephone Number	:	909-380-2046
Fax Number	:

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

Provider Enumeration Date	:	10/04/2018
Last Update Date	:	10/04/2018

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Directions to “ VICKI NGUYEN ” Practice Location

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