Individual
LAM MINH PHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
125 16TH AVE E, SEATTLE, WA 98112-5211
(206) 326-3000
Mailing address
125 16TH AVE E, SEATTLE, WA 98112-5211
(206) 326-3000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP60670623
WA
207Q00000X
Family Medicine Physician
OT015490
PA
207Q00000X
Family Medicine Physician
TO60695541
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2069156
—
WA
Enumeration date
12/12/2013
Last updated
05/04/2021
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