Provider Demographics
NPI:1063903953
Name:TRAN, NGUYEN-THAO BINH (DO)
Entity type:Individual
Prefix:DR
First Name:NGUYEN-THAO
Middle Name:BINH
Last Name:TRAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:THAO
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:3506 TALBOT RD S
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5746
Mailing Address - Country:US
Mailing Address - Phone:206-403-0764
Mailing Address - Fax:
Practice Address - Street 1:140 SW 146TH ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-1912
Practice Address - Country:US
Practice Address - Phone:206-901-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-25
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP61078153208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics