MEDICARE: NGOCLOAN THI 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	225700000X	Massage Therapist	MA60866321	WA

General Provider Information

NPI Number	:	1023581816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NGOCLOAN THI NGUYEN

Provider Business Mailing Address
First Line	:	4550 16TH AVE NE APT 1
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98105-4299
Country	:	US
Telephone Number	:	206-941-9510
Fax Number	:

Provider Business Practice Location Address
First Line	:	4550 16TH AVE NE APT 1
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98105-4299
Country	:	US
Telephone Number	:	206-941-9510
Fax Number	:

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

Provider Enumeration Date	:	01/04/2019
Last Update Date	:	01/04/2019

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Directions to “ NGOCLOAN THI NGUYEN ” Practice Location

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