Healthcare Provider Details

I. General information

NPI: 1205270584
Provider Name (Legal Business Name): YEN HOANG NGUYEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2013
Last Update Date: 08/17/2024
Certification Date: 08/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800 4TH AVE NE
SEATTLE WA
98115-2152
US

IV. Provider business mailing address

11511 SHADOW CREEK PKWY
PEARLAND TX
77584-7298
US

V. Phone/Fax

Practice location:
  • Phone: 206-302-1200
  • Fax: 877-516-8135
Mailing address:
  • Phone: 713-442-4997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberQ7437
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOP61516015
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: