Healthcare Provider Details

I. General information

NPI: 1083604078
Provider Name (Legal Business Name): NAM TRAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE DIVISION OF VASCULAR SURGERY
SEATTLE WA
98104-2420
US

IV. Provider business mailing address

BOX 359796 325 9TH AVE
SEATTLE WA
98104-2420
US

V. Phone/Fax

Practice location:
  • Phone: 206-731-8041
  • Fax:
Mailing address:
  • Phone: 206-731-8041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD00037473
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: