Provider Demographics
NPI:1578930491
Name:TRAN, TUAN TAYLOR THANH (DC)
Entity Type:Individual
Prefix:DR
First Name:TUAN TAYLOR
Middle Name:THANH
Last Name:TRAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SELAH
Mailing Address - State:WA
Mailing Address - Zip Code:98942-1339
Mailing Address - Country:US
Mailing Address - Phone:509-452-0738
Mailing Address - Fax:509-452-0743
Practice Address - Street 1:408 S 2ND ST
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-2816
Practice Address - Country:US
Practice Address - Phone:509-452-0738
Practice Address - Fax:509-452-0743
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60587929111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor