Provider Demographics
NPI:1053397000
Name:NGUYEN, HONG THI (OD)
Entity type:Individual
Prefix:DR
First Name:HONG
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 N 115TH ST
Mailing Address - Street 2:SUITE #110
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8401
Mailing Address - Country:US
Mailing Address - Phone:206-363-6003
Mailing Address - Fax:206-363-6003
Practice Address - Street 1:1536 N 115TH ST
Practice Address - Street 2:SUITE #110
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8401
Practice Address - Country:US
Practice Address - Phone:206-363-6003
Practice Address - Fax:206-363-6003
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3989152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1536NGOtherREGENCE BLUE SHIELD
WA203412OtherDEPT OF LABOR & INDUSTRY
WA2031177Medicaid
WA7601725OtherAETNA
WA203412OtherDEPT OF LABOR & INDUSTRY
WA8856587Medicare ID - Type Unspecified