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General NPI Number Information
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NPI Number | 1508825449
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Entity Type | Individual
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Provider Name | HA QUANG NGUYEN DPM
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Gender | Male
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 04/30/2012
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Provider Practice Location Address
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Address Line | 1206 S 11TH ST BLDG 2
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City | TACOMA
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State | WA
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Zip | 98405-4099
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Country | US
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Telephone | 253-272-0606
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Fax | 253-272-2118
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Provider Business Mailing Address
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Address Line | 1206 S 11TH ST BLDG 2
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City | TACOMA
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State | WA
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Zip | 98405-4099
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Country | US
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Telephone | 253-272-0606
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Fax | 253-272-2118
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO00000782
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License Number State | WA
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