MEDICARE: KIM VAN TRAN 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	208000000X	Pediatrics Physician	61457390	WA

General Provider Information

NPI Number	:	1699152397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM VAN TRAN M.D.

Provider Business Mailing Address
First Line	:	2475 140TH AVE NE BLDG C
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98005-1892
Country	:	US
Telephone Number	:	425-828-2257
Fax Number	:

Provider Business Practice Location Address
First Line	:	2475 140TH AVE NE BLDG C
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98005-1892
Country	:	US
Telephone Number	:	425-828-2257
Fax Number	:	425-896-7034

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

Provider Enumeration Date	:	05/01/2015
Last Update Date	:	05/08/2025

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