Healthcare Provider Details

I. General information

NPI: 1841104650
Provider Name (Legal Business Name): WAI PHYO THU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2219 RIMLAND DR STE 301
BELLINGHAM WA
98226-8759
US

IV. Provider business mailing address

6701 12TH AVE FL 1
BROOKLYN NY
11219-5912
US

V. Phone/Fax

Practice location:
  • Phone: 855-722-9700
  • Fax: 844-222-0800
Mailing address:
  • Phone: 929-204-8867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMDCE.ML.70170023
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: