Healthcare Provider Details

I. General information

NPI: 1790210557
Provider Name (Legal Business Name): BUTTERFLY MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2017
Last Update Date: 04/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13323 23RD PL NE APT B
SEATTLE WA
98125-4213
US

IV. Provider business mailing address

6850 35TH AVE NE SUITE 7
SEATTLE WA
98115-7344
US

V. Phone/Fax

Practice location:
  • Phone: 832-607-6501
  • Fax:
Mailing address:
  • Phone: 832-607-6501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT60248920
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberNT60692341
License Number StateWA

VIII. Authorized Official

Name: DR. THI HUONG NGUYEN-PHUOC
Title or Position: OWNER
Credential: ND, PT, LAC
Phone: 832-607-6501