Healthcare Provider Details

I. General information

NPI: 1053248187
Provider Name (Legal Business Name): CHRISTINE MICHELLE NGUYEN RN60297818
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US

IV. Provider business mailing address

19670 11TH PL S
DES MOINES WA
98148-2332
US

V. Phone/Fax

Practice location:
  • Phone: 206-764-2199
  • Fax:
Mailing address:
  • Phone: 206-764-2199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60297818
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: