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NPI Code Detail

MEDICARE: DR. HONG THI NGUYEN OD

MEDICARE: DR. HONG THI NGUYEN OD
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
1152W00000XOptometrist3989WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11536NGOTHERWAREGENCE BLUE SHIELD
2203412OTHERWADEPT OF LABOR & INDUSTRY
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
47601725OTHERWAAETNA

General Provider Information

NPI Number : 1053397000
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HONG THI NGUYEN OD
Provider Business Mailing Address
First Line : 1536 N 115TH ST
Second Line : SUITE #110
City : SEATTLE
State : WA
Zip : 98133-8401
Country : US
Telephone Number : 206-363-6003
Fax Number : 206-363-6003
Provider Business Practice Location Address
First Line : 1536 N 115TH ST
Second Line : SUITE #110
City : SEATTLE
State : WA
Zip : 98133-8401
Country : US
Telephone Number : 206-363-6003
Fax Number : 206-363-6003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2005
Last Update Date : 07/08/2007

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Directions to “ DR. HONG THI NGUYEN OD” Practice Location

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