Healthcare Provider Details

I. General information

NPI: 1821232695
Provider Name (Legal Business Name): PHI HUYNH L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2009
Last Update Date: 08/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15446 BELLEVUE REDMOND RD STE B15
REDMOND WA
98052-5507
US

IV. Provider business mailing address

11806 78TH AVE S
SEATTLE WA
98178-3816
US

V. Phone/Fax

Practice location:
  • Phone: 206-697-9540
  • Fax:
Mailing address:
  • Phone: 206-697-9540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC60076364
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: