Provider Demographics
NPI:1316191331
Name:NGHIEM, LYNN PHUONG (RDH)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:PHUONG
Last Name:NGHIEM
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MRS
Other - First Name:LYNN
Other - Middle Name:PHUONG
Other - Last Name:NGHIEM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DH00006972
Mailing Address - Street 1:PO BOX 34703
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7803 NE FOURTH PLN RD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-7294
Practice Address - Country:US
Practice Address - Phone:360-768-9030
Practice Address - Fax:360-768-9031
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH4635124Q00000X
WADH00006972124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist