Provider Demographics
NPI:1861215410
Name:NGUYEN, QUANG DUY (PHARMD)
Entity type:Individual
Prefix:
First Name:QUANG
Middle Name:DUY
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 N LYTER AVE
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-2554
Mailing Address - Country:US
Mailing Address - Phone:407-885-9507
Mailing Address - Fax:
Practice Address - Street 1:442 W SIMS WAY
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-1811
Practice Address - Country:US
Practice Address - Phone:360-385-2860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61572998183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty