IVAN WONG (NPI# 1043527146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043527146 |
| Entity Type | Individual |
| Full Name | IVAN WONG |
| Credential | PHARM.D. |
| Practice Address |
17615 140th Ave Se Renton WA 98058 |
| Mailing Address |
17615 140th Ave Se Renton WA 98058-6828 |
| Practice Telephone | 4252041585 |
| Practice Fax Number | 4252040743 |
| Mailing Telephone | 4252041585 |
| Mailing Fax Number | 4252040743 |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2010-09-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PH00063119 | WA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023170073 | Ivan Wong | Optometrist | 7 Backus Ave Ste 250, Danbury, CT 06810-7493 | 2006-12-15 |
| 1356608426 | Ivan Wong | Internal Medicine | 506 6th St, Brooklyn, NY 11215-3609 | 2012-04-13 |
| 1043472772 | Ivan Ho-bun Wong | Specialist | 6815 Noble Ave, Van Nuys, CA 91405-3796 | 2008-06-25 |
| Street Address |
17615 140TH AVE SE |
| City | RENTON |
| State | WA |
| Zip Code | 98058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881610061 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 17615 140th Ave Se, Renton, WA 98058-6828 | 2006-07-14 |
| 1073155792 | Peyton Nicole Andrews | Pharmacist | 17615 140th Ave Se, Renton, WA 98058-6828 | 2019-10-14 |
| 1487105516 | Pabita Shrestha | Pharmacist | 17615 140th Ave Se, Renton, WA 98058-6828 | 2016-10-24 |
| 1154581593 | Hana Ma | Pharmacist | 17615 140th Ave Se, Renton, WA 98058-6828 | 2008-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639799471 | Fairwood Dental LLC | Dentist | 14250 Se 176th #j7, Renton, WA 98058 | 2020-04-22 |
| 1538641386 | Kenneth Graber | Physical Therapist | 17650 140th Avenue Sw, Suite B-07, Renton, WA 98058 | 2018-08-29 |
| 1508210154 | Lucy Johnson | Specialist/Technologist | 11808 Se 172nd Ln Apt N303, Renton, WA 98058 | 2016-04-20 |
| 1104253947 | Bertila Martinez | Dental Hygienist | 14600 Se 176th St #v4, Renton, WA 98058 | 2013-10-10 |
| 1326340456 | Tabatha Burris | Specialist | 14410 Petrovistsky Rd Se #109, Renton, WA 98058 | 2010-11-22 |
| 1295042570 | Hanh Q Nguyen | Pharmacist | 16940 116th Avenue Southeast, Renton, WA 98058 | 2010-09-08 |
| 1861692675 | Ernestine Johanna Rombouts | Counselor | 16205 128th Place Se, Renton, WA 98058 | 2007-07-19 |
| 1912100991 | Cara Rozell | Pharmacist | 400 South 43rd St, Renton, WA 98058 | 2007-06-07 |
| 1699821231 | Lynne Suzanne Balderson | Massage Therapist | 14410 Se Petrovitsky Rd #201, Renton, WA 98058 | 2007-01-26 |
| 1023173465 | Sara Jean Denherder | Massage Therapist | 17070 - 140th Ave Se, Renton, WA 98058 | 2006-12-26 |
| Find all providers in zip 98058 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453988 | Phuong Tran Chan Nguyen | Pharmacist | 2826 Se 2nd Ct, Renton, WA 98056-4016 | 2020-10-07 |
| 1851930614 | Chau Minh Nguyen | Pharmacist | 763 Vashon Pl Ne, Renton, WA 98059-4714 | 2019-12-27 |
| 1275003220 | Nemesis Merly Torres | Pharmacist | 947 Powell Ave Sw # 422, Renton, WA 98057-2975 | 2018-12-03 |
| 1912481268 | Rimon Samir Fahmy Hanna | Pharmacist | 708 S 23rd St, Renton, WA 98055-4206 | 2018-09-22 |
| 1558868190 | Jenna Leah Belden | Pharmacist | 400 S 43rd St # 50010, Renton, WA 98055-5714 | 2018-04-10 |
| 1083131072 | Lindsey Helm | Pharmacist | 1135 Lake Washington Blvd N Unit G214, Renton, WA 98056-2943 | 2017-08-29 |
| 1497109490 | Allison R. Pham | Pharmacist | 10940 Se 187th Ln, Renton, WA 98055-8113 | 2016-04-16 |
| 1497112031 | Malcolm Thomas Morris | Pharmacist | 15603 Se 177th Pl, Renton, WA 98058-9008 | 2016-01-27 |
| 1841680568 | Bahador Poorahmary Kermany | Pharmacist | 1505 Pierce Ave Ne, Renton, WA 98056-3374 | 2015-02-02 |
| 1841695467 | Angelica Tran | Pharmacist | 455 Bronson Way North East, Renton, WA 98056 | 2014-10-24 |
| Find all providers in RENTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.