Provider Demographics
NPI:1811654205
Name:TRAN, PRESTON ANDERSON
Entity type:Individual
Prefix:
First Name:PRESTON
Middle Name:ANDERSON
Last Name:TRAN
Suffix:
Gender:
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 WESTLAKE AVE N STE 414
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2707
Mailing Address - Country:US
Mailing Address - Phone:206-737-1922
Mailing Address - Fax:
Practice Address - Street 1:1818 WESTLAKE AVE N STE 414
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2707
Practice Address - Country:US
Practice Address - Phone:206-737-1922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-20
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX940276163W00000X
WARN61457362163W00000X
WAAP61457369363L00000X
TX1070207363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse