Provider Demographics
NPI:1033175849
Name:LE, BAO XUYEN THI (CPHT)
Entity Type:Individual
Prefix:
First Name:BAO XUYEN
Middle Name:THI
Last Name:LE
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4157 145TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3111
Mailing Address - Country:US
Mailing Address - Phone:206-354-8881
Mailing Address - Fax:
Practice Address - Street 1:4157 145TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3111
Practice Address - Country:US
Practice Address - Phone:206-354-8881
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00061501183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician