Provider Demographics
NPI:1144309972
Name:LIEU, NGA THIEN (ARNP)
Entity type:Individual
Prefix:MISS
First Name:NGA
Middle Name:THIEN
Last Name:LIEU
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4739 1/2 RAINIER AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-1657
Mailing Address - Country:US
Mailing Address - Phone:206-725-0119
Mailing Address - Fax:206-725-8829
Practice Address - Street 1:4739 1/2 RAINIER AVE SOUTH
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-1657
Practice Address - Country:US
Practice Address - Phone:206-725-0119
Practice Address - Fax:206-725-8829
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005715363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9664624Medicaid
WAG8889358OtherMEDICARE PTAN
WAG8889358OtherMEDICARE PTAN