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General NPI Number Information
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NPI Number | 1578964581
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Entity Type | Individual
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Provider Name | LIEN THI NGUYEN RDH
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Gender | Female
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Dates
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Enumeration Date | 09/09/2014
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Last Update Date | 09/09/2014
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Provider Practice Location Address
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Address Line | 4630 NE 21ST PL
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City | RENTON
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State | WA
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Zip | 98059-3854
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Country | US
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Telephone | 206-595-8975
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Fax |
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Provider Business Mailing Address
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Address Line | 4630 NE 21ST PL
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City | RENTON
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State | WA
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Zip | 98059-3854
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Country | US
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Telephone | 206-595-8975
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH 00007939
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License Number State | WA
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