Provider Demographics
NPI:1386733483
Name:VU, GIANG VAN (PA)
Entity type:Individual
Prefix:MR
First Name:GIANG
Middle Name:VAN
Last Name:VU
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E 26TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98421-1108
Mailing Address - Country:US
Mailing Address - Phone:253-597-4550
Mailing Address - Fax:253-597-4556
Practice Address - Street 1:11225 PACIFIC AVE S
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-5525
Practice Address - Country:US
Practice Address - Phone:253-536-2020
Practice Address - Fax:253-536-5327
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10005057363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical