Provider Demographics
NPI:1326378415
Name:NGU, ISAAC (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:ISAAC
Middle Name:
Last Name:NGU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 NE 50TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4406
Mailing Address - Country:US
Mailing Address - Phone:206-204-0145
Mailing Address - Fax:206-204-0176
Practice Address - Street 1:1205 NE 50TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4406
Practice Address - Country:US
Practice Address - Phone:206-204-0145
Practice Address - Fax:206-204-0176
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00049638183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist