Healthcare Provider Details

I. General information

NPI: 1477473114
Provider Name (Legal Business Name): TIFFANY TRAM LUONG OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13033 NE BEL RED RD STE 130
BELLEVUE WA
98005-2633
US

IV. Provider business mailing address

13033 NE BEL RED RD STE 130
BELLEVUE WA
98005-2633
US

V. Phone/Fax

Practice location:
  • Phone: 877-852-2020
  • Fax:
Mailing address:
  • Phone: 877-852-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOD.OD.70136340
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: