Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | OP60929320 | WA |
N | 111NI0900X | Internist | OP60929320 | WA |
N | 207R00000X | Internist | OT017320 | PA |
N | 111NI0900X | Internist | OT017320 | PA |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | OP60929320 | WA |
NPI | 1063861813 |
---|---|
Provider Name | Anh My Tran |
First Address | Everett, WA 98206-5127 |
Second Address | Everett, WA 98201-4918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2016 |
Last Update Date | 06/08/2021 |