Basic Information
Provider Information
NPI: 1083865448
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NGUYEN
FirstName: TRAMANH
MiddleName: THI
NamePrefix:  
NameSuffix:  
Credential: MSW, MHP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3639 MARTIN LUTHER KING JR WAY S
Address2:  
City: SEATTLE
State: WA
PostalCode: 981446847
CountryCode: US
TelephoneNumber: 2066957600
FaxNumber: 2066957606
Practice Location
Address1: 3639 MARTIN LUTHER KING JR WAY S
Address2:  
City: SEATTLE
State: WA
PostalCode: 981446847
CountryCode: US
TelephoneNumber: 2066957600
FaxNumber: 2066957606
Other Information
ProviderEnumerationDate: 10/03/2008
LastUpdateDate: 11/02/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X  Y Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


Home