Provider Demographics
NPI:1396799870
Name:VU, LOAN N (MD)
Entity type:Individual
Prefix:
First Name:LOAN
Middle Name:N
Last Name:VU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13100 MILITARY RD S
Mailing Address - Street 2:STE 2
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-3086
Mailing Address - Country:US
Mailing Address - Phone:206-242-7333
Mailing Address - Fax:206-242-7335
Practice Address - Street 1:13100 MILITARY RD S
Practice Address - Street 2:STE 2
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-3086
Practice Address - Country:US
Practice Address - Phone:206-242-7333
Practice Address - Fax:206-242-7335
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY39682207Q00000X
WAMD00046816207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64090319Medicaid
WA8470510Medicaid
I16485Medicare UPIN
0996906Medicare ID - Type Unspecified