Provider Demographics
NPI:1114282928
Name:NGUYEN, THUY-AN TRAN (PHARM D)
Entity Type:Individual
Prefix:
First Name:THUY-AN
Middle Name:TRAN
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 PALOMINO DR SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-8630
Mailing Address - Country:US
Mailing Address - Phone:360-313-6689
Mailing Address - Fax:
Practice Address - Street 1:1206 PALOMINO DR SE
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-8630
Practice Address - Country:US
Practice Address - Phone:360-313-6689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-08
Last Update Date:2012-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 60251133183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist