Provider Demographics
NPI:1578831798
Name:TAN, SIUYEE (RPH)
Entity Type:Individual
Prefix:
First Name:SIUYEE
Middle Name:
Last Name:TAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 W 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-5251
Mailing Address - Country:US
Mailing Address - Phone:303-237-4392
Mailing Address - Fax:303-237-4399
Practice Address - Street 1:12700 W 32ND AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-5251
Practice Address - Country:US
Practice Address - Phone:303-237-4392
Practice Address - Fax:303-237-4399
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15583183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist