MEDICARE: CHANH TAM NGUYEN

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1013766039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANH TAM NGUYEN

Provider Business Mailing Address
First Line	:	505 LEGION WAY SE UNIT 204
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98501-1420
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	413 LILLY RD NE
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98506-5166
Country	:	US
Telephone Number	:	360-493-7525
Fax Number	:

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

Provider Enumeration Date	:	05/13/2024
Last Update Date	:	04/17/2026

Similar Medicare Providers

1649239534 — TERRENCE ANTHONY SCHULTE MD
Practice Location Address:

413 LILLY RD NE , PROVIDENCE ST PETER HOSPITAL
OLYMPIA, WA
98506-5166

Practice Phone: 360-491-9480
Practice Fax: 360-459-4361

1376502260 — CHARLES A RICHERT MD
Practice Location Address:

413 LILLY RD NE , PROVIDENCE ST PETER HOSPITAL
OLYMPIA, WA
98506-5166

Practice Phone: 360-491-9480
Practice Fax: 360-459-4361

1104885425 — RICHARD OSBORN WHITTEN MD
Practice Location Address:

413 LILLY RD NE , PROVIDENCE ST PETER HOSPITAL
OLYMPIA, WA
98506-5166

Practice Phone: 360-491-9480
Practice Fax: 360-459-4361

1780645366 — DENNIS F PECK MD
Practice Location Address:

413 LILLY ROAD NE , PROVIDENCE ST PETER HOSPITAL
OLYMPIA, WA
98506-5166

Practice Phone: 360-491-9480
Practice Fax: 360-459-4361

1326223801 — ARTHUR DAVID SIEK M.D.
Practice Location Address:

413 LILLY ROAD NE
OLYMPIA, WA
98506-5166

Practice Phone: 360-491-9480
Practice Fax:

1194991901 — FREDRICK SUNGJAE AN DO
Practice Location Address:

413 LILLY RD NE
OLYMPIA, WA
98506-5166

Practice Phone: 360-491-9480
Practice Fax: 360-456-2413

Directions to “ CHANH TAM NGUYEN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.