Provider Demographics
NPI:1205136926
Name:LUI, ED G (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ED
Middle Name:G
Last Name:LUI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:ED
Other - Middle Name:G
Other - Last Name:LUI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARM D
Mailing Address - Street 1:21401 PACIFIC HWY S
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-6074
Mailing Address - Country:US
Mailing Address - Phone:206-824-4784
Mailing Address - Fax:206-878-3208
Practice Address - Street 1:21401 PACIFIC HWY S
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-6074
Practice Address - Country:US
Practice Address - Phone:206-824-4784
Practice Address - Fax:206-878-3208
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00020682183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist