Provider Demographics
NPI:1821015728
Name:PASCUAL, THAO TRUONG (MD)
Entity Type:Individual
Prefix:DR
First Name:THAO
Middle Name:TRUONG
Last Name:PASCUAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 E RAY RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-8720
Mailing Address - Country:US
Mailing Address - Phone:855-397-0197
Mailing Address - Fax:800-272-6512
Practice Address - Street 1:2707 COLBY AVE STE 718
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3528
Practice Address - Country:US
Practice Address - Phone:425-339-5413
Practice Address - Fax:425-339-4213
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00038825207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1019735Medicaid
WAMD00038825OtherLICENSE
WA8385585Medicaid
WA1019735Medicaid
WA8385585Medicaid
WAMD00038825OtherLICENSE