Provider Demographics
NPI:1841947520
Name:CHIANG, KATRINA SHIN YU (RPH)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:SHIN YU
Last Name:CHIANG
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 1:16225 12TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2809
Mailing Address - Country:US
Mailing Address - Phone:206-504-9993
Mailing Address - Fax:
Practice Address - Street 1:4412 RAINIER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-1373
Practice Address - Country:US
Practice Address - Phone:206-720-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61184363183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist