Provider Demographics
NPI:1154336535
Name:DUONG, HONGHUE T (PA)
Entity type:Individual
Prefix:
First Name:HONGHUE
Middle Name:T
Last Name:DUONG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 8TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3032
Mailing Address - Country:US
Mailing Address - Phone:206-788-3700
Mailing Address - Fax:206-788-3706
Practice Address - Street 1:720 8TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3032
Practice Address - Country:US
Practice Address - Phone:206-788-3700
Practice Address - Fax:206-788-3706
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10001081363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8373532Medicaid
WA0199428OtherL&I PIN
WADU6331OtherREGENCE BLUE SHIELD
WAU53388OtherREGENCE BLUE SHIELD PIN
WAAB20526Medicare PIN
WA8373532Medicaid
WA8854768Medicare PIN