Individual
JONATHAN PHU-TRUNG NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
REV.
Contact information
Practice address
9100 BRIDGEPORT WAY SW, LAKEWOOD, WA 98499-2427
(253) 302-3826
Mailing address
7801 59TH AVE W, LAKEWOOD, WA 98499-8571
(253) 228-5317
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101Y99995L
WA
Other
Enumeration date
05/02/2023
Last updated
05/02/2023
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