Provider Demographics
NPI:1699146696
Name:NGUYEN, THUAN HUY (CRNA)
Entity type:Individual
Prefix:
First Name:THUAN
Middle Name:HUY
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:DAMON
Other - Middle Name:HUY
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:505 NE 87TH AVE
Mailing Address - Street 2:SUITE 46.5
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-1989
Mailing Address - Country:US
Mailing Address - Phone:360-828-5396
Mailing Address - Fax:360-828-5455
Practice Address - Street 1:2211 NE 139TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-2742
Practice Address - Country:US
Practice Address - Phone:360-828-5396
Practice Address - Fax:360-828-5455
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-15
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR108234282N00000X
WAAP60624584367500000X
WARN60624581163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No282N00000XHospitalsGeneral Acute Care Hospital
No163W00000XNursing Service ProvidersRegistered Nurse