Provider Demographics
NPI:1255924635
Name:TRUONG, THUC HOANG (PHARMD)
Entity type:Individual
Prefix:
First Name:THUC
Middle Name:HOANG
Last Name:TRUONG
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 1:18001 BOTHELL EVERETT HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1660
Mailing Address - Country:US
Mailing Address - Phone:425-402-6485
Mailing Address - Fax:425-486-0106
Practice Address - Street 1:18001 BOTHELL EVERETT HWY STE 101
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-1660
Practice Address - Country:US
Practice Address - Phone:425-402-6485
Practice Address - Fax:425-486-0106
Is Sole Proprietor?:No
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIR60794783183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist