Provider Demographics
NPI:1659185189
Name:NGUYEN, PHUONG CAM TU
Entity type:Individual
Prefix:
First Name:PHUONG CAM TU
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 HEWITT AVE APT 304
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3672
Mailing Address - Country:US
Mailing Address - Phone:206-255-0984
Mailing Address - Fax:
Practice Address - Street 1:1804 HEWITT AVE APT 304
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3672
Practice Address - Country:US
Practice Address - Phone:206-255-0984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA13498171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter