Provider Demographics
NPI:1952737934
Name:VU, QUANG MY (PHARMACIST)
Entity type:Individual
Prefix:
First Name:QUANG
Middle Name:MY
Last Name:VU
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11701 SE 78TH PL
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98056-9112
Mailing Address - Country:US
Mailing Address - Phone:206-228-1426
Mailing Address - Fax:
Practice Address - Street 1:1702 AUBURN WAY N STE A
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-3372
Practice Address - Country:US
Practice Address - Phone:253-804-9616
Practice Address - Fax:253-804-9622
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00011053183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist