Provider Demographics
NPI:1861476129
Name:TA, CINDY NGUYEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CINDY
Middle Name:NGUYEN
Last Name:TA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 59TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-3513
Mailing Address - Country:US
Mailing Address - Phone:206-935-0492
Mailing Address - Fax:
Practice Address - Street 1:120 N 85TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-3602
Practice Address - Country:US
Practice Address - Phone:206-784-7601
Practice Address - Fax:206-783-8938
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00061078183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist