Provider Demographics
NPI:1528727823
Name:HUYNH, KHOI TRUNG
Entity type:Individual
Prefix:
First Name:KHOI
Middle Name:TRUNG
Last Name:HUYNH
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 1:12567 SE 76TH CT
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98056-1343
Mailing Address - Country:US
Mailing Address - Phone:206-483-7849
Mailing Address - Fax:
Practice Address - Street 1:12567 SE 76TH CT
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:WA
Practice Address - Zip Code:98056-1343
Practice Address - Country:US
Practice Address - Phone:206-483-7849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC56387171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter