Individual provider Active NPI

Thuy-Trang T Hahn, ARNP

  • Nurse Practitioner
  • Bonney Lake, WA
National Provider Identifier
1639688302
Registry record updated Sep 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60797697 Issued in WA
Practice address
10004 204TH Ave E Ste 3400
Bonney Lake, WA 98391-6536
Phone
(253) 848-5951
NPI assigned
Sep 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60797697 WA Primary

Addresses

Primary practice location

10004 204TH Ave E Ste 3400
Bonney Lake, WA 98391-6536

Mailing address

3908 10TH St SE
Puyallup, WA 98374-2188
Phone (253) 848-5951

Other identifiers 1

IdentifierTypeStateIssuer
AP60797697OtherWAARNP LICENSE

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
I20171128002167 WA Practitioner - Nurse Practitioner 9032476155 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60797697WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Hill Family Medicine PC CurrentSince Nov 7, 2017 Accepting new patients
Cascade Eye & Skin Centers PC PastSince Nov 7, 2017 Accepting new patients

Locations

10004 204th Ave E
Ste 3400
Bonney Lake, WA 98391
Phone (253) 841-9640

611 31st Ave SW
Ste C
Puyallup, WA 98373
Phone (253) 848-5951

11216 Sunrise Blvd E
Ste 3-106
Puyallup, WA 98374
Phone (253) 341-0698

3908 10th St SE
Puyallup, WA 98374
Phone (253) 848-5951

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": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506384000000",
    "number": "1639688302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3908 10TH ST SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742188",
            "telephone_number": "253-848-5951",
            "fax_number": "253-845-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 204TH AVE E STE 3400",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916536",
            "telephone_number": "253-848-5951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAHN",
        "first_name": "THUY-TRANG",
        "middle_name": "T",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2017-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60797697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE",
            "identifier": "AP60797697",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

Verify at the official NPI Registry.