Individual provider Active NPI

Ai-VI Ivy Tran, MD

  • Student in an Organized Health Care Education/Training Program
  • Tacoma, WA
National Provider Identifier
1770255341
Registry record updated Apr 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
315 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Phone
(253) 792-6680
NPI assigned
Oct 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234

Mailing address

315 Martin Luther King Jr. Way Mailstop 315-5C-TFM
Tacoma, WA 98405

Other practice location 1

34515 9th Ave S
Federal Way, WA 98003-6761
Phone (253) 944-8100

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230712003254 WA Order and Referring Only - Family PracticePractitioner - Family Practice 8224498092

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682726400000",
    "number": "1770255341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MARTIN LUTHER KING JR. WAY MAILSTOP 315-5C-TFM",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054234",
            "telephone_number": "253-792-6680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34515 9th Ave S",
            "address_purpose": "LOCATION",
            "city": "Federal Way",
            "state": "WA",
            "postal_code": "980036761",
            "country_code": "US",
            "telephone_number": "253-944-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAN",
        "first_name": "AI-VI",
        "middle_name": "IVY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2023-04-29",
        "certification_date": "2023-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.