Provider Demographics
NPI:1457504201
Name:NGUYEN, HA THU (MA)
Entity Type:Individual
Prefix:MS
First Name:HA
Middle Name:THU
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 OLYMPIA AVE NE
Mailing Address - Street 2:BOX 20, SUITE 312
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-4117
Mailing Address - Country:US
Mailing Address - Phone:253-279-4299
Mailing Address - Fax:
Practice Address - Street 1:401 OLYMPIA AVE NE
Practice Address - Street 2:SUITE 312
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-4117
Practice Address - Country:US
Practice Address - Phone:253-279-4299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00008608101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health