Provider Demographics
NPI:1093149494
Name:DINH, NGHIEM (OD)
Entity Type:Individual
Prefix:DR
First Name:NGHIEM
Middle Name:
Last Name:DINH
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 1:10990 HARBOR HILL DR
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-8945
Mailing Address - Country:US
Mailing Address - Phone:253-853-8613
Mailing Address - Fax:253-853-8614
Practice Address - Street 1:10990 HARBOR HILL DR
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-8945
Practice Address - Country:US
Practice Address - Phone:626-673-3319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2020-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60511809152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2107403Medicaid