1598083107 NPI number — MRS. THUY DIEM NGUYEN LE RPH

Table of content: MRS. THUY DIEM NGUYEN LE RPH (NPI 1598083107)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598083107 NPI number — MRS. THUY DIEM NGUYEN LE RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NGUYEN LE
Provider First Name:
THUY
Provider Middle Name:
DIEM
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NGUYEN
Provider Other First Name:
THUY
Provider Other Middle Name:
DIEM
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMACIST
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1598083107
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9714 NE MILL PLAIN BOULEVARD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VANCOUVER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98664
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-253-7254
Provider Business Mailing Address Fax Number:
360-253-7827

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9714 NE MILL PLAIN BOULEVARD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98664
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-253-7254
Provider Business Practice Location Address Fax Number:
360-253-7827
Provider Enumeration Date:
05/06/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  PH00041443 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 18350000041443 . This is a "PHARMACY SERVICE PROVIDER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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