Provider Demographics
NPI:1629601265
Name:DO, ANDREW TRAN
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:TRAN
Last Name:DO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 49TH ST NE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422-4617
Mailing Address - Country:US
Mailing Address - Phone:253-224-6558
Mailing Address - Fax:
Practice Address - Street 1:3401 49TH ST NE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98422-4617
Practice Address - Country:US
Practice Address - Phone:253-226-5083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program