Provider Demographics
NPI:1982169967
Name:CHAN, PUI SZE (PHARMD)
Entity Type:Individual
Prefix:
First Name:PUI
Middle Name:SZE
Last Name:CHAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34520 16TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6802
Mailing Address - Country:US
Mailing Address - Phone:253-835-4976
Mailing Address - Fax:
Practice Address - Street 1:34520 16TH AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6802
Practice Address - Country:US
Practice Address - Phone:253-835-4976
Practice Address - Fax:253-835-4979
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60883398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist