Provider Demographics
NPI:1366985715
Name:TANG, CAROLINE (PHARMD)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:TANG
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 1:6520 23RD AVE NE
Mailing Address - Street 2:APT. 301
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6000
Mailing Address - Country:US
Mailing Address - Phone:734-709-3673
Mailing Address - Fax:
Practice Address - Street 1:18805 STATE ROUTE 2
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1438
Practice Address - Country:US
Practice Address - Phone:360-805-8133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIPH60675436183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist