Healthcare Provider Details

I. General information

NPI: 1487186722
Provider Name (Legal Business Name): VIET P.H. NGUYEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 07/23/2020
Certification Date: 07/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10521 MERIDIAN AVE N
SEATTLE WA
98133-9509
US

IV. Provider business mailing address

PO BOX 3835
SEATTLE WA
98124-3835
US

V. Phone/Fax

Practice location:
  • Phone: 206-296-4990
  • Fax: 206-205-5142
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60968357
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: