Individual provider Active NPI

Phandinh Ngoc Nguyen, ND, MD

  • Naturopath
  • Renton, WA
National Provider Identifier
1548716152
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
NT60616795 Issued in WA
Practice address
330 SW 43Rd St,Suite L
Renton, WA 98057
Phone
(425) 324-4745
Fax
(253) 981-4815
NPI assigned
Sep 1, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X NT60616795 WA Primary

Addresses

Primary practice location

330 SW 43Rd St,Suite L
Renton, WA 98057

Mailing address

330 SW 43Rd St Ste L
Renton, WA 98057-4900
Phone (425) 324-4745

Other identifiers 1

IdentifierTypeStateIssuer
2061470MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Phandinh Clinic-Urgent Care and Wellness Center PC CurrentSince Feb 8, 2023 Accepting new patients
Phandinh Clinic-Urgent Care & Wellness Center PC CurrentSince Oct 15, 2023 Accepting new patients

Locations

5406 W Glenn Dr
Ste 3
Glendale, AZ 85301
Phone (623) 270-6336

Organizations & group practices 2

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": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1548716152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SW 43RD ST STE L",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574900",
            "telephone_number": "425-324-4745",
            "fax_number": "253-981-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 SW 43RD ST,SUITE L",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "98057",
            "telephone_number": "425-324-4745",
            "fax_number": "253-981-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHANDINH",
        "middle_name": "NGOC",
        "name_prefix": "Dr.",
        "credential": "ND, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "WA",
            "license": "NT60616795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2061470",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.