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NPI Code Detail

MEDICARE: MS. TIEN DO PA-C

MEDICARE: MS. TIEN DO PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2363A00000XPhysician AssistantAK

General Provider Information

NPI Number : 1407374325
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TIEN DO PA-C
Provider Business Mailing Address
First Line : PO BOX 5517
Second Line :
City : PORTLAND
State : OR
Zip : 97228-5517
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4311 11TH AVE NE STE 200
Second Line :
City : SEATTLE
State : WA
Zip : 98105-6367
Country : US
Telephone Number : 206-616-4001
Fax Number : 206-616-3889
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2017
Last Update Date : 07/21/2022

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Directions to “ MS. TIEN DO PA-C” Practice Location

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