Provider Demographics
NPI:1134349574
Name:SAGADIEV, PATRICIA TUYET (RPH)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:TUYET
Last Name:SAGADIEV
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:TUYET
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1210 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:POST ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362
Mailing Address - Country:US
Mailing Address - Phone:301-807-4016
Mailing Address - Fax:
Practice Address - Street 1:424 E 2ND ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-3119
Practice Address - Country:US
Practice Address - Phone:360-452-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16248183500000X
CO18609183500000X
WAPH60568836183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist