Provider Demographics
NPI:1053547232
Name:TRAN, DIEM-PHUONG NGOC (DO)
Entity type:Individual
Prefix:
First Name:DIEM-PHUONG
Middle Name:NGOC
Last Name:TRAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:8609 EVERGREEN WAY
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-2619
Mailing Address - Country:US
Mailing Address - Phone:425-789-3700
Mailing Address - Fax:425-789-3780
Practice Address - Street 1:1019 112TH ST SW
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-4875
Practice Address - Country:US
Practice Address - Phone:425-551-6200
Practice Address - Fax:425-551-6017
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2020-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
COTL-3267207Q00000X
WAOP60368373207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine