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General NPI Number Information
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NPI Number | 1629232921
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Entity Type | Individual
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Provider Name | JENNY TRUONG O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/16/2008
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 908 JEFFERSON ST
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City | SEATTLE
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State | WA
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Zip | 98104-2433
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Country | US
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Telephone | 206-520-5000
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Fax | 206-897-4939
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Provider Business Mailing Address
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Address Line | 15600 NE 8TH ST STE B1105
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City | BELLEVUE
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State | WA
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Zip | 98008-3927
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Country | US
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Telephone | 425-749-1752
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT 13694 TLG
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 60066487
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License Number State | WA
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