Provider Demographics
NPI:1639294218
Name:POON, ANTON H (RPH)
Entity Type:Individual
Prefix:
First Name:ANTON
Middle Name:H
Last Name:POON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11625 SE 49TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-2713
Mailing Address - Country:US
Mailing Address - Phone:206-890-7701
Mailing Address - Fax:
Practice Address - Street 1:17220 REDMOND WAY
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4403
Practice Address - Country:US
Practice Address - Phone:425-883-0607
Practice Address - Fax:425-883-4555
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00039867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist