Healthcare Provider Details

I. General information

NPI: 1427686088
Provider Name (Legal Business Name): AUSTIN NGUYEN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4455 148TH AVE NE # B1
BELLEVUE WA
98007-3120
US

IV. Provider business mailing address

601 BROADWAY FL 7
SEATTLE WA
98122-5330
US

V. Phone/Fax

Practice location:
  • Phone: 206-386-2600
  • Fax:
Mailing address:
  • Phone: 206-386-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOP61581499
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberDO.OP.61581499
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: