Healthcare Provider Details

I. General information

NPI: 1205356276
Provider Name (Legal Business Name): MINH HANG DAO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 5TH AVE # P100
SEATTLE WA
98104-3176
US

IV. Provider business mailing address

PO BOX 25608
SALT LAKE CITY UT
84125-0608
US

V. Phone/Fax

Practice location:
  • Phone: 206-320-3351
  • Fax: 206-554-7787
Mailing address:
  • Phone: 206-320-4476
  • Fax: 206-568-7043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOP60977377
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: