Provider Demographics
NPI:1164926028
Name:TRINH, MINH VAN
Entity type:Individual
Prefix:
First Name:MINH
Middle Name:VAN
Last Name:TRINH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 3RD ST NE STE 200
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4035
Mailing Address - Country:US
Mailing Address - Phone:253-275-1000
Mailing Address - Fax:
Practice Address - Street 1:125 3RD ST NE STE 200
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4035
Practice Address - Country:US
Practice Address - Phone:253-275-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY56970207W00000X
OH35.145114207W00000X
390200000X
WAIMLC.MD.61517591207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program