Provider Demographics
NPI:1942592696
Name:TANG, NORMAN
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:
Last Name:TANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 622
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-0622
Mailing Address - Country:US
Mailing Address - Phone:360-325-4310
Mailing Address - Fax:360-325-4320
Practice Address - Street 1:2057 ALDER STREET
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:WA
Practice Address - Zip Code:98248
Practice Address - Country:US
Practice Address - Phone:360-325-4310
Practice Address - Fax:360-325-4320
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00049969183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist