Provider Demographics
NPI:1063713196
Name:TRAN, MICHELLE KIM (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:KIM
Last Name:TRAN
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 1:9262 RAINIER AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-5570
Mailing Address - Country:US
Mailing Address - Phone:206-494-1139
Mailing Address - Fax:206-494-1124
Practice Address - Street 1:9262 RAINIER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-5570
Practice Address - Country:US
Practice Address - Phone:206-494-1130
Practice Address - Fax:206-494-1124
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH40329183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist