Individual provider Active NPI

Eric Lam Nguyen, DPT

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1578342887
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61476219 Issued in WA
Practice address
4617 37TH Ave SW
Seattle, WA 98126-2749
Phone
(206) 614-0256
Fax
(206) 767-2822
NPI assigned
Sep 26, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT61476219 WA Primary

Addresses

Primary practice location

4617 37TH Ave SW
Seattle, WA 98126-2749

Mailing address

3724 Walnut Ave SW
Seattle, WA 98116-3838
Phone (206) 953-0349

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT61476219WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Pines Physical Therapy PLLC Physical Therapist CurrentSince Oct 1, 2023 Accepting new patients

Locations

4617 37th Ave SW
Seattle, WA 98126
Phone (206) 614-0256

Organizations & group practices 1

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": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1578342887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 WALNUT AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981163838",
            "telephone_number": "206-953-0349",
            "fax_number": "206-767-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4617 37TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981262749",
            "telephone_number": "206-614-0256",
            "fax_number": "206-767-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ERIC",
        "middle_name": "LAM",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61476219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.