Provider Demographics
NPI:1093046542
Name:VO, TUONG
Entity Type:Individual
Prefix:
First Name:TUONG
Middle Name:
Last Name:VO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 N MARION ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-5524
Mailing Address - Country:US
Mailing Address - Phone:206-427-3508
Mailing Address - Fax:253-394-0080
Practice Address - Street 1:1509 N MARION ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5524
Practice Address - Country:US
Practice Address - Phone:206-427-3508
Practice Address - Fax:253-394-0080
Is Sole Proprietor?:No
Enumeration Date:2010-01-22
Last Update Date:2017-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60009915183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist