Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | MD60128113 | WA |
NPI | 1013232842 |
---|---|
Provider Name | Dr. Henry Nguyen |
First Address | Bremerton, WA 98310-2851 |
Second Address | Bremerton, WA 98310-2851 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2010 |
Last Update Date | 12/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0262067 | L&I WASHINGTON STATE (01) | WA |