Provider Demographics
NPI:1033313820
Name:TRAN, LONG DUC (MD)
Entity Type:Individual
Prefix:
First Name:LONG
Middle Name:DUC
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:85 WINOOSKI FALLS WAY
Mailing Address - Street 2:#313
Mailing Address - City:WINOOSKI
Mailing Address - State:VT
Mailing Address - Zip Code:05404-2262
Mailing Address - Country:US
Mailing Address - Phone:214-529-4257
Mailing Address - Fax:
Practice Address - Street 1:315 MARTIN LUTHER KING JR. WAY
Practice Address - Street 2:MAILSTOP 315-J1--TRAUMA
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98415-0299
Practice Address - Country:US
Practice Address - Phone:253-403-4570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD 601584822086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP2-0019297OtherINSTITUTIONAL PERMIT