Provider Demographics
NPI:1972316586
Name:LE, BAO NGOC HAN (NC 61634244)
Entity type:Individual
Prefix:
First Name:BAO NGOC
Middle Name:HAN
Last Name:LE
Suffix:
Gender:F
Credentials:NC 61634244
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4908 NE 7TH PL
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059-4678
Mailing Address - Country:US
Mailing Address - Phone:206-710-6778
Mailing Address - Fax:
Practice Address - Street 1:4908 NE 7TH PL
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98059-4678
Practice Address - Country:US
Practice Address - Phone:206-710-6778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61634244376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide