Healthcare Provider Details

I. General information

NPI: 1518219468
Provider Name (Legal Business Name): LOC NGUYEN R.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2012
Last Update Date: 10/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3013 S MOUNT BAKER BLVD
SEATTLE WA
98144-6139
US

IV. Provider business mailing address

3013 S MOUNT BAKER BLVD
SEATTLE WA
98144-6139
US

V. Phone/Fax

Practice location:
  • Phone: 206-252-6157
  • Fax: 206-252-6344
Mailing address:
  • Phone: 206-252-6157
  • Fax: 206-252-6344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN60086512
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: