Healthcare Provider Details

I. General information

NPI: 1093052011
Provider Name (Legal Business Name): LINH THUY TRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2013
Last Update Date: 01/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST MAIL BOX 356078
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

1959 NE PACIFIC ST MAIL BOX 356078
SEATTLE WA
98195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-4628
  • Fax:
Mailing address:
  • Phone: 206-598-4628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00142613
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number11068032
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: