Provider Demographics
NPI:1346455987
Name:NGUYEN, ROSALIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:
Last Name:NGUYEN
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 1:1112 6TH AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4040
Mailing Address - Country:US
Mailing Address - Phone:253-572-0180
Mailing Address - Fax:253-561-0018
Practice Address - Street 1:1112 6TH AVE
Practice Address - Street 2:STE 101
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4040
Practice Address - Country:US
Practice Address - Phone:253-572-0180
Practice Address - Fax:253-561-0018
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00067579183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist