Healthcare Provider Details

I. General information

NPI: 1144064122
Provider Name (Legal Business Name): ANNIE MAI NHI NGUYEN BA, CPC, CHES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2008 WESTLAKE AVE STE 100
SEATTLE WA
98121-2695
US

IV. Provider business mailing address

108 167TH PL SW
BOTHELL WA
98012-5967
US

V. Phone/Fax

Practice location:
  • Phone: 206-956-9570
  • Fax:
Mailing address:
  • Phone: 206-372-5327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number61581685
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: