Provider Demographics
NPI:1215191747
Name:LUCAS, QUYEN NGUYEN (PHARM D)
Entity Type:Individual
Prefix:
First Name:QUYEN
Middle Name:NGUYEN
Last Name:LUCAS
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 1:4118 148TH ST SW
Mailing Address - Street 2:UNIT K4
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-5573
Mailing Address - Country:US
Mailing Address - Phone:206-518-8971
Mailing Address - Fax:
Practice Address - Street 1:10116 NE 8TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4148
Practice Address - Country:US
Practice Address - Phone:425-454-2468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2012-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60015231183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist