Provider Demographics
NPI:1891103453
Name:NGUYEN, YEN XUAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:YEN
Middle Name:XUAN
Last Name:NGUYEN
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 1:17432 SE 270TH PL
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-4962
Mailing Address - Country:US
Mailing Address - Phone:253-630-8682
Mailing Address - Fax:253-630-8715
Practice Address - Street 1:17432 SE 270TH PL
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-4962
Practice Address - Country:US
Practice Address - Phone:253-630-8682
Practice Address - Fax:253-630-8715
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00055492183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist