Provider Demographics
NPI:1659915692
Name:LU, TSU YUAN (RPH)
Entity Type:Individual
Prefix:
First Name:TSU YUAN
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:
Other - Last Name:LU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:6432 STATE HIGHWAY 303 NE
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-3714
Mailing Address - Country:US
Mailing Address - Phone:360-307-8741
Mailing Address - Fax:360-307-8745
Practice Address - Street 1:6432 STATE HIGHWAY 303 NE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-3714
Practice Address - Country:US
Practice Address - Phone:360-307-8741
Practice Address - Fax:360-307-8745
Is Sole Proprietor?:No
Enumeration Date:2019-11-02
Last Update Date:2019-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60956388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist