Healthcare Provider Details

I. General information

NPI: 1043353568
Provider Name (Legal Business Name): TRAM TUYET TRUONG D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MADIGAN ARMY MEDICAL CTR BUILDING 9040 FITZSIMMONS DR
TACOMA WA
98431-0001
US

IV. Provider business mailing address

1982 CHARLES ST
DUPONT WA
98327-7740
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-0208
  • Fax:
Mailing address:
  • Phone: 408-244-2859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A 9845
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: