Provider Demographics
NPI:1154694628
Name:CHEUNG, ALICE FUNG (RPH)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:FUNG
Last Name:CHEUNG
Suffix:
Gender:
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 LAKE DR
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-8115
Mailing Address - Country:US
Mailing Address - Phone:425-313-2725
Mailing Address - Fax:
Practice Address - Street 1:730 LAKE DR
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5504
Practice Address - Country:US
Practice Address - Phone:425-313-2725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00040287183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist