| Doctor Name: | DR. PHU TAN NGUYEN |
| NPI Number: | 1447284971 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 23644 |
| Business Practice Address: | 210 N G Street #g Tacoma, WA - 98403 |
| Business Phone Number: | 2403538893 |
| Business Fax Number: | |
| Mailing Address: | 210 N G Street #g, TACOMA |
| State: | WA |
| Postal Code: | 98403 |
| Phone Number: | 2403538893 |
| Fax Number: | |
| NPI Enumeration Date: | 07/10/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 23644 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |