Provider Demographics
NPI:1861965287
Name:NGUYO, NEWTON SAMMY (LPN)
Entity type:Individual
Prefix:MR
First Name:NEWTON
Middle Name:SAMMY
Last Name:NGUYO
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6312 S 239TH ST APT N301
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-3805
Mailing Address - Country:US
Mailing Address - Phone:903-422-0148
Mailing Address - Fax:
Practice Address - Street 1:6312 S 239TH ST APT N301
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-3805
Practice Address - Country:US
Practice Address - Phone:903-422-0148
Practice Address - Fax:903-422-0148
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60909033164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Single Specialty