Healthcare Provider Details

I. General information

NPI: 1134756190
Provider Name (Legal Business Name): TAMMY LUAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MADISON ST STE 510
SEATTLE WA
98104-3557
US

IV. Provider business mailing address

4060 FOURTH AVE STE 510
SAN DIEGO CA
92103-2121
US

V. Phone/Fax

Practice location:
  • Phone: 206-386-6600
  • Fax:
Mailing address:
  • Phone: 619-686-4011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA208483
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberA208483
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: