Provider Demographics
NPI:1013627751
Name:TEH, MELISSA PEK SUN (RPH)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:PEK SUN
Last Name:TEH
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 1:10777 MAIN ST STE 516
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6978
Mailing Address - Country:US
Mailing Address - Phone:425-531-6324
Mailing Address - Fax:
Practice Address - Street 1:6619 132ND AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8627
Practice Address - Country:US
Practice Address - Phone:425-881-5678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60708473183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist