Provider Demographics
NPI:1336478221
Name:DAO, TAI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TAI
Middle Name:
Last Name:DAO
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 1:1215 NE 148TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-7135
Mailing Address - Country:US
Mailing Address - Phone:206-306-9131
Mailing Address - Fax:206-363-3512
Practice Address - Street 1:14510 AURORA AVE N
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-6525
Practice Address - Country:US
Practice Address - Phone:206-361-8826
Practice Address - Fax:306-363-3512
Is Sole Proprietor?:No
Enumeration Date:2009-12-23
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00022398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPH00022398OtherWA STATE CREDENTIAL NUMBER