Provider Demographics
NPI:1811247570
Name:DANG, VINCENT QUOC (PHARMD)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:QUOC
Last Name:DANG
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 1:3224 21ST CT SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-2893
Mailing Address - Country:US
Mailing Address - Phone:503-806-5175
Mailing Address - Fax:
Practice Address - Street 1:4280 MARTIN WAY E
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98516-5354
Practice Address - Country:US
Practice Address - Phone:360-456-7132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60288125183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist