Provider Demographics
NPI:1831463892
Name:PHAM, LELE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LELE
Middle Name:
Last Name:PHAM
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 1:6100 E LAKE SAMMAMISH PKWY SE
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-8926
Mailing Address - Country:US
Mailing Address - Phone:425-416-1133
Mailing Address - Fax:425-416-1127
Practice Address - Street 1:6100 E LAKE SAMMAMISH PKWY SE
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029-8926
Practice Address - Country:US
Practice Address - Phone:425-416-1133
Practice Address - Fax:425-416-1127
Is Sole Proprietor?:No
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00018688183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist