Individual
LONG T PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10631 8TH AVE NE, SEATTLE, WA 98125-7213
(206) 361-7410
Mailing address
10631 8TH AVE NE, SEATTLE, WA 98125-7213
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60772353
WA
Other
Enumeration date
10/11/2018
Last updated
10/11/2018
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