Provider Demographics
NPI:1003197971
Name:VO, TUONG NGOC (OD)
Entity Type:Individual
Prefix:
First Name:TUONG
Middle Name:NGOC
Last Name:VO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 SOUTHCENTER MALL
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2810
Mailing Address - Country:US
Mailing Address - Phone:206-243-2322
Mailing Address - Fax:206-209-0002
Practice Address - Street 1:301 SOUTHCENTER MALL
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2810
Practice Address - Country:US
Practice Address - Phone:206-243-2322
Practice Address - Fax:206-209-0002
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7940TG152W00000X
WAOD60384269152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist