Provider Demographics
NPI:1093584112
Name:TRAN, MY VAN HOANG (PHARMD)
Entity Type:Individual
Prefix:
First Name:MY VAN
Middle Name:HOANG
Last Name:TRAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10427 OCCIDENTAL AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98168-1315
Mailing Address - Country:US
Mailing Address - Phone:206-765-6790
Mailing Address - Fax:
Practice Address - Street 1:10427 OCCIDENTAL AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98168-1315
Practice Address - Country:US
Practice Address - Phone:206-765-6790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61310608183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist