Provider Demographics
NPI:1417382144
Name:LIAO, CHIA WEI (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHIA WEI
Middle Name:
Last Name:LIAO
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 1:4410 6TH AVE SE
Mailing Address - Street 2:UNIT #106
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-1064
Mailing Address - Country:US
Mailing Address - Phone:310-993-7286
Mailing Address - Fax:
Practice Address - Street 1:413 LILLY RD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5133
Practice Address - Country:US
Practice Address - Phone:360-493-5432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60375685183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist