Provider Demographics
NPI:1518088707
Name:NGUYEN, TRAN THANH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TRAN
Middle Name:THANH
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 1:27944 25TH PL S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-2720
Mailing Address - Country:US
Mailing Address - Phone:206-257-9416
Mailing Address - Fax:253-931-1150
Practice Address - Street 1:1509 AUBURN WAY S
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-6739
Practice Address - Country:US
Practice Address - Phone:253-939-1939
Practice Address - Fax:253-931-1150
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00060318183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist