Individual provider Active NPI

Phuong Le, ARNP

  • Nurse Practitioner
  • Renton, WA
National Provider Identifier
1497389886
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP61175056 Issued in WA
Practice address
4509 Talbot Rd S Ste 105
Renton, WA 98055-6294
Phone
(360) 350-9230
Fax
(253) 627-6576
NPI assigned
Feb 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP61175056 WA Primary
Registered Nurse 163W00000X RN60289892 WA

Addresses

Primary practice location

4509 Talbot Rd S Ste 105
Renton, WA 98055-6294

Mailing address

4509 Talbot Rd S Ste 105
Renton, WA 98055-6294
Phone (206) 776-4411

Other identifiers 1

IdentifierTypeStateIssuer
2180716MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250321000749 WA Practitioner - Nurse Practitioner 4880090869 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Washington School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1107 U St NW
Auburn, WA 98001-3856
Phone (360) 350-9230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rhema Aesthetics and Wellness PLLC CurrentSince Jan 1, 2025 Accepting new patients
Rhema Healing & Wound Care LLC CurrentSince Apr 29, 2025 Accepting new patients

Locations

4509 Talbot Rd S
Ste 105G
Renton, WA 98055
Phone (206) 776-4411

4509 Talbot Rd S
Ste 105
Renton, WA 98055
Phone (206) 776-4411

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1497389886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4509 TALBOT RD S STE 105",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556294",
            "telephone_number": "206-776-4411",
            "fax_number": "425-276-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4509 TALBOT RD S STE 105",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556294",
            "telephone_number": "360-350-9230",
            "fax_number": "253-627-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "PHUONG",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-25",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61175056",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60289892",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2180716",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.