Provider Demographics
NPI:1104001395
Name:NGUYEN, THU THUY (LMP)
Entity type:Individual
Prefix:MRS
First Name:THU
Middle Name:THUY
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15210 NE 8TH ST APT D6
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-4834
Mailing Address - Country:US
Mailing Address - Phone:425-681-1273
Mailing Address - Fax:425-614-0679
Practice Address - Street 1:14100 SE 36TH ST STE 100
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1675
Practice Address - Country:US
Practice Address - Phone:425-614-0680
Practice Address - Fax:425-614-0679
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024736225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist