Provider Demographics
NPI:1851697072
Name:NGUYEN, PHI-LAN HOANG (LAC, EAMP)
Entity Type:Individual
Prefix:
First Name:PHI-LAN
Middle Name:HOANG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:LAC, EAMP
Other - Prefix:
Other - First Name:Y LAN
Other - Middle Name:HOANG
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSAOM, EAMP, LAC
Mailing Address - Street 1:12600 SE 38TH ST STE 130
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-6105
Mailing Address - Country:US
Mailing Address - Phone:425-679-6056
Mailing Address - Fax:206-577-5375
Practice Address - Street 1:12600 SE 38TH ST
Practice Address - Street 2:STE. #130
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-6105
Practice Address - Country:US
Practice Address - Phone:425-679-6056
Practice Address - Fax:206-577-5375
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-04
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60205633171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAC60205633OtherLICENSE