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NPI Code Detail

MEDICARE: TAM QUACH DO

MEDICARE: TAM QUACH DO
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
1208100000XPhysical Medicine & Rehabilitation PhysicianOP61126242WA

General Provider Information

NPI Number : 1154713071
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAM QUACH DO
Provider Business Mailing Address
First Line : PO BOX 74008272
Second Line :
City : CHICAGO
State : IL
Zip : 60674-8272
Country : US
Telephone Number : 702-899-0595
Fax Number : 702-977-1496
Provider Business Practice Location Address
First Line : 2821 S WALDEN ST
Second Line :
City : SEATTLE
State : WA
Zip : 98144-6830
Country : US
Telephone Number : 206-577-6200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2015
Last Update Date : 10/02/2025

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Directions to “ TAM QUACH DO” Practice Location

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