1114238524 NPI number — DRS. AUDREY T & THAI V. NGUYEN, PLLC

Table of content: MONICA YOUNGEUN CHOE CRNP (NPI 1598338634)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114238524 NPI number — DRS. AUDREY T & THAI V. NGUYEN, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRS. AUDREY T & THAI V. NGUYEN, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
EDC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114238524
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5717 PINNACLE CT NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TACOMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98422
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-272-6242
Provider Business Mailing Address Fax Number:
253-272-6243

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3415 AUBURN WAY S
Provider Second Line Business Practice Location Address:
STE #1
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-272-6242
Provider Business Practice Location Address Fax Number:
253-272-6242
Provider Enumeration Date:
06/30/2010

Additional Information

Authorized Official

Authorized Official Last Name:
NGUYEN
Authorized Official First Name:
AUDREY
Authorized Official Middle Name:
T
Authorized Official Title or Position:
VP
Authorized Official Telephone Number:
253-272-6242

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: TBA , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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