Individual
MR. SIMON T TANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
19710 131ST PL NE, WOODINVILLE, WA 98072
(425) 483-1449
Mailing address
19710 131ST PL NE, WOODINVILLE, WA 98072-5766
(425) 483-1449
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH 00040150
WA
261Q00000X
Clinic/Center
Primary
PH 00040150
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH 0040150
WA STATE DEPARTMENT OF HEALTH
WA
Enumeration date
07/18/2012
Last updated
07/18/2012
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