Basic Information
Provider Information
NPI: 1750329561
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRAN
FirstName: LINH
MiddleName: V.
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3934
Address2:  
City: SEATTLE
State: WA
PostalCode: 981243934
CountryCode: US
TelephoneNumber: 4253533788
FaxNumber: 4253538041
Practice Location
Address1: 1550 N 115TH ST
Address2:  
City: SEATTLE
State: WA
PostalCode: 981338401
CountryCode: US
TelephoneNumber: 4253533788
FaxNumber: 4253538041
Other Information
ProviderEnumerationDate: 06/03/2006
LastUpdateDate: 11/19/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XMD00038271WAY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
829989305WA MEDICAID


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