Provider Demographics
NPI:1265558910
Name:TRAN, PETER D (RPH)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:D
Last Name:TRAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 S 38TH CT
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5895
Mailing Address - Country:US
Mailing Address - Phone:206-214-8730
Mailing Address - Fax:
Practice Address - Street 1:9000C RAINIER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-5025
Practice Address - Country:US
Practice Address - Phone:206-760-1076
Practice Address - Fax:206-760-2655
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00040307183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist