Provider Demographics
NPI:1184985368
Name:CHIEM, TAI (PHARMD)
Entity type:Individual
Prefix:MR
First Name:TAI
Middle Name:
Last Name:CHIEM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 145TH PL SE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-5593
Mailing Address - Country:US
Mailing Address - Phone:425-653-2431
Mailing Address - Fax:425-653-2596
Practice Address - Street 1:1510 145TH PL SE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-5593
Practice Address - Country:US
Practice Address - Phone:425-653-2431
Practice Address - Fax:425-653-2596
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00057505183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist