Provider Demographics
NPI:1205200185
Name:CHU, STEPHANIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:CHU
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:PO BOX 13994
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98082-1994
Mailing Address - Country:US
Mailing Address - Phone:425-293-6987
Mailing Address - Fax:
Practice Address - Street 1:14701 179TH AVE SE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1108
Practice Address - Country:US
Practice Address - Phone:360-863-4680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-16
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIR60431987390200000X
WAPH60862143183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program