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General NPI Number Information
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NPI Number | 1750005260
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Entity Type | Individual
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Provider Name | LAN PHUONG THI NGO RN
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Gender | Female
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Dates
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Enumeration Date | 09/28/2022
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 1200 INTREPID AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19112-1229
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Country | US
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Telephone | 206-235-2370
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Fax |
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Provider Business Mailing Address
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Address Line | 11516 SE 316TH PL
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City | AUBURN
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State | WA
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Zip | 98092-5311
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Country | US
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Telephone | 206-235-2370
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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 | 163WR0400X
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Taxonomy Name | Rehabilitation Registered Nurse
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License Number | RN60632748
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License Number State | WA
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