Provider Demographics
NPI:1578795910
Name:WU, CHUNG CHIEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHUNG
Middle Name:CHIEN
Last Name:WU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 BROADWAY STE ET-144
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4379
Mailing Address - Country:US
Mailing Address - Phone:206-751-1345
Mailing Address - Fax:206-751-1346
Practice Address - Street 1:747 BROADWAY STE ET-144
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4379
Practice Address - Country:US
Practice Address - Phone:206-751-1345
Practice Address - Fax:206-751-1346
Is Sole Proprietor?:No
Enumeration Date:2009-08-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0011001183500000X
WAPH605234411835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMRP00006974OtherPHARMACIST LICENSE
ORRPH0011001OtherPHARMACIST LICENSE
WAPH60523441OtherPHARMACIST LICENSE