Healthcare Provider Details

I. General information

NPI: 1578052890
Provider Name (Legal Business Name): NUONG TRUONG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 NE 139TH ST
VANCOUVER WA
98686-2719
US

IV. Provider business mailing address

2525 NE 139TH ST
VANCOUVER WA
98686-2719
US

V. Phone/Fax

Practice location:
  • Phone: 608-822-7783
  • Fax:
Mailing address:
  • Phone: 608-822-7783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberMD.MD.61648988
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: