Provider Demographics
NPI:1124080734
Name:NGUYEN, BICH-KHANH T (MD)
Entity type:Individual
Prefix:DR
First Name:BICH-KHANH
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 216TH ST SW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8006
Mailing Address - Country:US
Mailing Address - Phone:425-640-4901
Mailing Address - Fax:425-640-4919
Practice Address - Street 1:7320 216TH ST SW
Practice Address - Street 2:SUITE 200
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8006
Practice Address - Country:US
Practice Address - Phone:425-640-4901
Practice Address - Fax:425-640-4919
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00028424207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA39114OtherLABOR AND INDUSTRIES
WA1079136Medicaid
7358256OtherAETNA
WAR52987OtherREGENCE
R52987OtherBLUE CROSS/BLUE SHIELD
E99272Medicare UPIN