Provider Demographics
NPI:1568737898
Name:WANG, YOWHWA GRACE (PHD,MS, BS)
Entity Type:Individual
Prefix:
First Name:YOWHWA
Middle Name:GRACE
Last Name:WANG
Suffix:
Gender:F
Credentials:PHD,MS, BS
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD,BS
Mailing Address - Street 1:17667 NE 76TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-4994
Mailing Address - Country:US
Mailing Address - Phone:425-556-8033
Mailing Address - Fax:
Practice Address - Street 1:17667 NE 76TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4994
Practice Address - Country:US
Practice Address - Phone:425-556-8033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2012-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00020156183500000X
CARPH44935183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist