Healthcare Provider Details

I. General information

NPI: 1194178780
Provider Name (Legal Business Name): DAVID NGOC TRAN CEO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2016
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3123 FAIRVIEW AVE E STE 200
SEATTLE WA
98102-3051
US

IV. Provider business mailing address

3123 FAIRVIEW AVE E STE 200
SEATTLE WA
98102-3051
US

V. Phone/Fax

Practice location:
  • Phone: 206-669-4171
  • Fax: 206-339-9544
Mailing address:
  • Phone: 206-650-6864
  • Fax: 206-339-9544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberMR60846454
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberNM0049261107E
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number1831957026
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNM
# 5
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberWDL77143J53B
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1194178780
License Number StateWA
# 7
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberPC60777046
License Number StateWA
# 8
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: