Provider Demographics
NPI:1407465073
Name:DANG, TU NGOC LE
Entity Type:Individual
Prefix:
First Name:TU
Middle Name:NGOC LE
Last Name:DANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 UNIVERSITY PKWY # K-274
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98901-8221
Mailing Address - Country:US
Mailing Address - Phone:714-728-8220
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY PKWY # K-274
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-8221
Practice Address - Country:US
Practice Address - Phone:714-728-8220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIR60958579183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist