Provider Demographics
NPI:1770120511
Name:BUI, THI VAN I
Entity type:Individual
Prefix:
First Name:THI VAN
Middle Name:
Last Name:BUI
Suffix:I
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 1:1818 NE 175TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-5273
Mailing Address - Country:US
Mailing Address - Phone:206-805-9028
Mailing Address - Fax:
Practice Address - Street 1:1818 NE 175TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-5273
Practice Address - Country:US
Practice Address - Phone:206-805-9028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-27
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program