Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DE00007936 | WA |
Y | 213EG0000X | General Practice | DE00007936 | WA |
NPI | 1003940446 |
---|---|
Provider Name | Tony Sieu |
First Address | Redmond, WA 98053-2033 |
Second Address | Redmond, WA 98053-2033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 08/07/2007 |