Provider Demographics
NPI:1164789681
Name:OH, DA YOUNG (RPH)
Entity Type:Individual
Prefix:
First Name:DA YOUNG
Middle Name:
Last Name:OH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18685 NE 63RD WAY APT 103
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-0532
Mailing Address - Country:US
Mailing Address - Phone:425-898-4751
Mailing Address - Fax:
Practice Address - Street 1:18685 NE 63RD WAY APT 103
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-0532
Practice Address - Country:US
Practice Address - Phone:425-898-4751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60213384183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist