Healthcare Provider Details

I. General information

NPI: 1669006904
Provider Name (Legal Business Name): TUATHAL LE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2020
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date: 01/20/2021
Reactivation Date: 11/26/2025

III. Provider practice location address

33455 6TH AVE S STE 2C
FEDERAL WAY WA
98003-6074
US

IV. Provider business mailing address

33455 6TH AVE S STE 2C
FEDERAL WAY WA
98003-6074
US

V. Phone/Fax

Practice location:
  • Phone: 253-210-4230
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP.AP.70120779-NP
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN60596235
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: