Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MD60488999 | WA |
NPI | 1104050814 |
---|---|
Provider Name | Hao Trong Vu |
First Address | Tacoma, WA 98405-5304 |
Second Address | Tacoma, WA 98405-5304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2009 |
Last Update Date | 18/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2039688 | (05) | WA |