Basic Information
| Provider Information | |||||||||
| NPI: | 1396260790 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WONG | ||||||||
| FirstName: | LEH CHING | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARM.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1040 S HENDERSON ST | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981084720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2067635277 | ||||||||
| FaxNumber: | 2067883204 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 N LAVENTURE RD | ||||||||
| Address2: | |||||||||
| City: | MOUNT VERNON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982732766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3605428800 | ||||||||
| FaxNumber: | 3605428797 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2017 | ||||||||
| LastUpdateDate: | 08/07/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | PH00039453 | WA | N | Pharmacy Service Providers | Pharmacist | 1835P2201X | PH00039453 | WA | Y |
No ID Information.