Healthcare Provider Details

I. General information

NPI: 1245141787
Provider Name (Legal Business Name): MR. HUNG NGUYEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16549 AURORA AVE N
SHORELINE WA
98133-5308
US

IV. Provider business mailing address

16549 AURORA AVE N
SHORELINE WA
98133-5308
US

V. Phone/Fax

Practice location:
  • Phone: 206-880-2144
  • Fax: 206-490-4011
Mailing address:
  • Phone: 206-880-2144
  • Fax: 206-490-4011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: