Individual
CLEMENT PHUONG NGUYEN LE THANH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
320 S KITSAP BLVD, PORT ORCHARD, WA 98366
(360) 876-7215
Mailing address
PO BOX 960, 400 WARREN AVE STE 300, BREMERTON, WA 98337
(360) 475-3709
(360) 373-2096
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00046845
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8465742
—
WA
Enumeration date
09/14/2006
Last updated
02/20/2008
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