Provider Demographics
NPI:1154641868
Name:NGUYEN, TRUC (ARNP)
Entity Type:Individual
Prefix:
First Name:TRUC
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 21ST AVE W
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98199-2304
Mailing Address - Country:US
Mailing Address - Phone:425-344-3974
Mailing Address - Fax:
Practice Address - Street 1:1728 W MARINE VIEW DR STE 109
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-2094
Practice Address - Country:US
Practice Address - Phone:425-252-9216
Practice Address - Fax:425-252-8637
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60590912363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health