Healthcare Provider Details

I. General information

NPI: 1184720179
Provider Name (Legal Business Name): NGOC LE HUYNH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 04/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13100 MILITARY RD S
TUKWILA WA
98168-3086
US

IV. Provider business mailing address

13100 MILITARY RD S
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 Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number39003
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00046713
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: