Basic Information
| Provider Information | |||||||||
| NPI: | 1942328216 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NG | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | PHARMD, LAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 167TH PL SW | ||||||||
| Address2: | |||||||||
| City: | BOTHELL | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980124913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252469518 | ||||||||
| FaxNumber: | 4257418395 | ||||||||
| Practice Location | |||||||||
| Address1: | 1700 13TH ST | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982011689 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252612000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2007 | ||||||||
| LastUpdateDate: | 04/18/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171100000X | AC00002182 | WA | N | Other Service Providers | Acupuncturist | 183500000X | PH60232960 | WA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.