Provider Demographics
NPI:1518732031
Name:DUONG-BUI, JENNY (DPT)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:DUONG-BUI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 NE 4TH ST STE 112
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-4100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3901 NE 4TH ST STE 112
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-4100
Practice Address - Country:US
Practice Address - Phone:425-616-3841
Practice Address - Fax:425-390-7425
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61498945225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist