Provider Demographics
NPI:1649750266
Name:VOIGT, NINA CHAN THACH (MD)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:CHAN THACH
Last Name:VOIGT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:CHAN
Other - Last Name:THACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1322 3RD ST SE STE 240
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-3771
Mailing Address - Country:US
Mailing Address - Phone:253-697-1420
Mailing Address - Fax:253-697-1439
Practice Address - Street 1:1322 3RD ST SE STE 240
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3771
Practice Address - Country:US
Practice Address - Phone:253-697-1420
Practice Address - Fax:253-697-1439
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WA61329804207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA02450921OtherKAISER PERMANENTE