MEDICARE: DR. QUYNH THANH BUI M.D.

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	207Q00000X	Family Medicine Physician	MD00040487	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5865BU	OTHER		REGENCE BLUESHIELD
2	7022424	OTHER		AETNA
3	172448	OTHER	WA	L&I
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639286388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. QUYNH THANH BUI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 24911
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98124-0911
Country	:	US
Telephone Number	:	206-788-3600
Fax Number	:

Provider Business Practice Location Address
First Line	:	3815 S OTHELLO ST
Second Line	:	2ND FLOOR
City	:	SEATTLE
State	:	WA
Zip	:	98118-3510
Country	:	US
Telephone Number	:	206-788-3535
Fax Number	:

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	12/17/2021

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