Provider Demographics
NPI:1417976440
Name:VU, LINH NGOC (MD)
Entity Type:Individual
Prefix:DR
First Name:LINH
Middle Name:NGOC
Last Name:VU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 169TH ST S
Mailing Address - Street 2:SUITE A
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-8201
Mailing Address - Country:US
Mailing Address - Phone:253-536-2824
Mailing Address - Fax:253-536-3070
Practice Address - Street 1:144 169TH ST S
Practice Address - Street 2:SUITE A
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-8201
Practice Address - Country:US
Practice Address - Phone:253-536-2824
Practice Address - Fax:253-536-3070
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037704207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0269995OtherSTATE L&I
WAG8903548OtherMEDICARE
WA0231163OtherSTATE L&I
WA0231147OtherSTATE L&I
WA8250888Medicaid
WA0224331OtherSTATE L&I
WA0224334OtherSTATE L&I
WA0240879OtherSTATE L&I
WA0152900OtherSTATE L&I
WA0224332OtherSTATE L&I
WA0284143OtherL&I
WAGAB33512Medicare PIN
WAG8903548OtherMEDICARE
WA0231163OtherSTATE L&I
WA0152900OtherSTATE L&I
WA0240879OtherSTATE L&I
WAH09897Medicare UPIN