Healthcare Provider Details

I. General information

NPI: 1053426734
Provider Name (Legal Business Name): SEATAC PRIMARY CARE PHYSICIANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 06/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13100 MILITARY RD S STE #2
TUKWILA WA
98168-3086
US

IV. Provider business mailing address

13100 MILITARY RD S STE #2
TUKWILA WA
98168-3086
US

V. Phone/Fax

Practice location:
  • Phone: 206-242-7333
  • Fax: 206-242-7335
Mailing address:
  • Phone: 206-242-7333
  • Fax: 206-242-7335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00042278
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00042368
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00046713
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00046816
License Number StateWA

VIII. Authorized Official

Name: DR. ANDY-LINH HUNG VU
Title or Position: CEO
Credential: M.D.
Phone: 206-242-7333