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NPI Code Detail

MEDICARE: DR. NGUYETHANG VU PHAM MD

MEDICARE: DR. NGUYETHANG VU PHAM MD
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
1207Q00000XFamily Medicine PhysicianMD61528941WA
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1548847916
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NGUYETHANG VU PHAM MD
Provider Business Mailing Address
First Line : PO BOX 5127
Second Line :
City : EVERETT
State : WA
Zip : 98206-5127
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 904 7TH AVE
Second Line :
City : SEATTLE
State : WA
Zip : 98104-1132
Country : US
Telephone Number : 206-860-4413
Fax Number : 206-624-9520
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2021
Last Update Date : 01/21/2026

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