Provider Demographics
NPI:1821372608
Name:NGUYEN, YEN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:YEN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 COSTCO DR STE 150
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-4808
Mailing Address - Country:US
Mailing Address - Phone:206-575-8147
Mailing Address - Fax:206-574-7150
Practice Address - Street 1:400 COSTCO DR STE 150
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-4808
Practice Address - Country:US
Practice Address - Phone:206-575-8147
Practice Address - Fax:206-574-7150
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00040315183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist