Provider Demographics
NPI:1639286388
Name:BUI, QUYNH THANH (MD)
Entity Type:Individual
Prefix:DR
First Name:QUYNH
Middle Name:THANH
Last Name:BUI
Suffix:
Gender:F
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:PO BOX 24911
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-0911
Mailing Address - Country:US
Mailing Address - Phone:206-788-3600
Mailing Address - Fax:
Practice Address - Street 1:3815 S OTHELLO ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-3510
Practice Address - Country:US
Practice Address - Phone:206-788-3535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00040487207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
5865BUOtherREGENCE BLUESHIELD
7022424OtherAETNA
WA172448OtherL&I
WA8319162Medicaid
WAAB36889Medicare PIN
5865BUOtherREGENCE BLUESHIELD