Provider Demographics
NPI:1760843619
Name:DOAN, HOANG-OANH THI (DO)
Entity Type:Individual
Prefix:DR
First Name:HOANG-OANH
Middle Name:THI
Last Name:DOAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:OANH
Other - Middle Name:
Other - Last Name:DOAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:14403 34TH AVE S
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-4301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:63 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-2386
Practice Address - Country:US
Practice Address - Phone:617-924-6484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-18
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA278251207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program