Healthcare Provider Details

I. General information

NPI: 1629325568
Provider Name (Legal Business Name): MARIA NGUYEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2012
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 NE ROMANCE HILL RD STE 105
BELFAIR WA
98528-8315
US

IV. Provider business mailing address

21 NE ROMANCE HILL RD STE 105
BELFAIR WA
98528-8315
US

V. Phone/Fax

Practice location:
  • Phone: 360-277-2975
  • Fax: 360-277-2980
Mailing address:
  • Phone: 360-277-2975
  • Fax: 360-277-2980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.MD.60971876
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: