Provider Demographics
NPI:1003401605
Name:YU, LOLITA (PHARMACIST LICENSE)
Entity Type:Individual
Prefix:
First Name:LOLITA
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:PHARMACIST LICENSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18721 40TH AVE W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-7613
Mailing Address - Country:US
Mailing Address - Phone:425-697-6613
Mailing Address - Fax:
Practice Address - Street 1:1200 112TH AVE NE STE A102
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3708
Practice Address - Country:US
Practice Address - Phone:425-289-0347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00018952183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist