Provider Demographics
NPI:1841752516
Name:TRUONG, HAI QUAN NGOC (MD)
Entity Type:Individual
Prefix:MR
First Name:HAI QUAN
Middle Name:NGOC
Last Name:TRUONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:QUAN
Other - Middle Name:
Other - Last Name:TRUONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:800 SENECA ST APT 1110
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-0020
Mailing Address - Country:US
Mailing Address - Phone:253-327-9521
Mailing Address - Fax:
Practice Address - Street 1:125 16TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5211
Practice Address - Country:US
Practice Address - Phone:206-326-3000
Practice Address - Fax:206-326-3659
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAML60962585207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program