Provider Demographics
NPI:1134410269
Name:THIEU, BECKY NGOC (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BECKY
Middle Name:NGOC
Last Name:THIEU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3524 NW PRINCETON LN
Mailing Address - Street 2:APT 14-107
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8145
Mailing Address - Country:US
Mailing Address - Phone:843-743-3225
Mailing Address - Fax:
Practice Address - Street 1:3201 NW RANDALL WAY
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7952
Practice Address - Country:US
Practice Address - Phone:360-536-6010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-23
Last Update Date:2011-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60154434183500000X
MNMN120241183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist