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General NPI Number Information
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NPI Number | 1154790798
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Entity Type | Individual
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Provider Name | HAN NGUYEN DC
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Gender | Female
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Dates
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Enumeration Date | 09/24/2015
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Last Update Date | 11/14/2017
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Provider Practice Location Address
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Address Line | 15811 AMBAUM BLVD SW SUITE 110
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City | BURIEN
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State | WA
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Zip | 98166
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Country | US
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Telephone | 206-242-8211
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Fax |
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Provider Business Mailing Address
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Address Line | 6003 SE 2ND STREET
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City | RENTON
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State | WA
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Zip | 98059
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH60567150
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License Number State | WA
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