Provider Demographics
NPI:1790006336
Name:MAU, NANCY KA-YAN (RPH)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:KA-YAN
Last Name:MAU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6517 63RD ST W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98467-4947
Mailing Address - Country:US
Mailing Address - Phone:253-460-6053
Mailing Address - Fax:
Practice Address - Street 1:26200 PACIFIC HWY S
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-6934
Practice Address - Country:US
Practice Address - Phone:253-941-4660
Practice Address - Fax:253-946-8492
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00049213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist