Provider Demographics
NPI:1578127478
Name:NGUYEN, KATHY PHUONG
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:PHUONG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 SW 337TH PL
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-3200
Mailing Address - Country:US
Mailing Address - Phone:206-883-3726
Mailing Address - Fax:
Practice Address - Street 1:110 2ND ST SW STE 140
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-5203
Practice Address - Country:US
Practice Address - Phone:253-737-5078
Practice Address - Fax:253-216-2821
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician