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Individual

PHUC NGOC NGUYEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
SUDPT

Contact information

Practice address
9100 BRIDGEPORT WAY SW, LAKEWOOD, WA 98499-2427
(253) 302-3826
Mailing address
3914 NE 10TH ST, RENTON, WA 98056-3585
(206) 483-9729

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61354051
WA

Other

Enumeration date
09/07/2022
Last updated
09/07/2022
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