Provider Demographics
NPI:1679027296
Name:NGUYEN, TUAN
Entity type:Individual
Prefix:
First Name:TUAN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4615 196TH ST SW
Mailing Address - Street 2:STE 175
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-5561
Mailing Address - Country:US
Mailing Address - Phone:425-670-0233
Mailing Address - Fax:425-670-0242
Practice Address - Street 1:4615 196TH ST SW
Practice Address - Street 2:STE 175
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5561
Practice Address - Country:US
Practice Address - Phone:425-670-0233
Practice Address - Fax:425-670-0242
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60978333183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist