MEDICARE: CANH TRAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1013413582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANH TRAN

Provider Business Mailing Address
First Line	:	4730 UNIVERSITY WAY NE STE 104
Second Line	:	#2125
City	:	SEATTLE
State	:	WA
Zip	:	98105-4424
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 9TH AVE NE
Second Line	:	SUITE 300
City	:	SEATTLE
State	:	WA
Zip	:	98105-4424
Country	:	US
Telephone Number	:	253-652-2161
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2018
Last Update Date	:	07/31/2021

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