Provider Demographics
NPI:1194178780
Name:TRAN, DAVID NGOC (CEO)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:NGOC
Last Name:TRAN
Suffix:
Gender:M
Credentials:CEO
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Mailing Address - Street 1:2820 EASTLAKE AVE E APT 304
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3097
Mailing Address - Country:US
Mailing Address - Phone:206-650-6864
Mailing Address - Fax:
Practice Address - Street 1:3123 FAIRVIEW AVE E STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3051
Practice Address - Country:US
Practice Address - Phone:206-669-4171
Practice Address - Fax:206-339-9544
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-19
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAWDL77143J53B172A00000X
NM106S00000X, 374U00000X
WA1194178780207Q00000X
WAPC60777046246RP1900X
WAMR60846454247200000X
NMNM0049261107E251J00000X
WA1831957026291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No172A00000XOther Service ProvidersDriverGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No251J00000XAgenciesNursing Care
No374U00000XNursing Service Related ProvidersHome Health Aide