Provider Demographics
NPI:1962475228
Name:YU, PETER TAK-KWONG (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:TAK-KWONG
Last Name:YU
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 SW 4TH PL
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-2329
Mailing Address - Country:US
Mailing Address - Phone:206-291-6856
Mailing Address - Fax:253-968-0560
Practice Address - Street 1:9040 REID ST
Practice Address - Street 2:MADIGAN ARMY MEDICAL CENTER, ATTN: MCHJ-QCR
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1100
Practice Address - Country:US
Practice Address - Phone:253-968-1181
Practice Address - Fax:253-968-0560
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA11664183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist