Provider Demographics
NPI:1598083107
Name:NGUYEN LE, THUY DIEM (RPH)
Entity Type:Individual
Prefix:MRS
First Name:THUY
Middle Name:DIEM
Last Name:NGUYEN LE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:THUY
Other - Middle Name:DIEM
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:9714 NE MILL PLAIN BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664
Mailing Address - Country:US
Mailing Address - Phone:360-253-7254
Mailing Address - Fax:360-253-7827
Practice Address - Street 1:9714 NE MILL PLAIN BOULEVARD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664
Practice Address - Country:US
Practice Address - Phone:360-253-7254
Practice Address - Fax:360-253-7827
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00041443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA18350000041443OtherPHARMACY SERVICE PROVIDER