Provider Demographics
NPI:1558344382
Name:NGUYEN, VO DANG (MD)
Entity Type:Individual
Prefix:DR
First Name:VO
Middle Name:DANG
Last Name:NGUYEN
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 1:3525 ENSIGN RD NE
Mailing Address - Street 2:STE K
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5065
Mailing Address - Country:US
Mailing Address - Phone:360-413-8121
Mailing Address - Fax:360-413-8865
Practice Address - Street 1:3525 ENSIGN RD NE
Practice Address - Street 2:SUITE K
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5065
Practice Address - Country:US
Practice Address - Phone:360-413-8121
Practice Address - Fax:360-413-8865
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00029070207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8132755Medicaid
AB20376Medicare ID - Type Unspecified
A78536Medicare UPIN