Active NPI
Van Nguyen, PHARM. D
- Pharmacotherapy Pharmacist
- Issaquah, WA
National Provider Identifier
1154659738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- PH60747679
- Practice address
- 755 NW Gilman Blvd
Issaquah, WA 98027-5357 - Phone
- (425) 507-1020
- NPI assigned
- Nov 19, 2009
- Last updated
- Mar 17, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 46174 | TX | |
| Pharmacotherapy Pharmacist | 1835P1200X | PH60747679 | WA | Primary |
Addresses
Primary practice location
755 NW Gilman Blvd
Issaquah, WA 98027-5357
Mailing address
755 NW Gilman Blvd
Issaquah, WA 98027-5357
Other practice location 1
6795 Calder Ave
Beaumont, TX 77706-6007
Phone (409) 860-3909
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 462289 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46174 | TX | MD | Pharmacist |
| PH60747679 | WA | MD | Pharmacotherapy Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1154659738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 NW GILMAN BLVD",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980275357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 NW GILMAN BLVD",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980275357",
"telephone_number": "425-507-1020"
}
],
"practiceLocations": [
{
"address_1": "6795 Calder Ave",
"address_purpose": "LOCATION",
"city": "Beaumont",
"state": "TX",
"postal_code": "777066007",
"country_code": "US",
"telephone_number": "409-860-3909",
"fax_number": "409-861-0578",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGUYEN",
"first_name": "VAN",
"name_prefix": "Dr.",
"credential": "PHARM. D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-19",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "46174",
"primary": false
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "WA",
"license": "PH60747679",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "462289",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Issaquah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.