Provider Demographics
NPI:1619761764
Name:NGUYEN, MAILE
Entity type:Individual
Prefix:
First Name:MAILE
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5517 NE 2ND ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059-4869
Mailing Address - Country:US
Mailing Address - Phone:206-883-9626
Mailing Address - Fax:
Practice Address - Street 1:4207 KITSAP WAY # MS 334-01
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-2447
Practice Address - Country:US
Practice Address - Phone:360-782-7709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-05
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program