Provider Demographics
NPI:1588056568
Name:LE, QUYNH PHUONG (DO)
Entity type:Individual
Prefix:
First Name:QUYNH
Middle Name:PHUONG
Last Name:LE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1100 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-341-0060
Mailing Address - Fax:206-625-7245
Practice Address - Street 1:2980 SQUALICUM PKWY STE 302
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1880
Practice Address - Country:US
Practice Address - Phone:360-788-8200
Practice Address - Fax:360-788-8329
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK182190208600000X
WAOP61146099208600000X, 2086X0206X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program