Individual provider Active NPI

Lisa Thu Nguyen, ARNP

  • Family Nurse Practitioner
  • Puyallup, WA
National Provider Identifier
1881241461
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60991328 Issued in WA
Practice address
1322 3Rd St SE Ste 300
Puyallup, WA 98372-3771
Phone
(253) 697-1420
NPI assigned
Aug 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60991328 WA Primary

Addresses

Primary practice location

1322 3Rd St SE Ste 300
Puyallup, WA 98372-3771

Mailing address

16515 Meridian E Ste 104a
Puyallup, WA 98375-6255
Phone (253) 792-6650

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
I20191104001976 WA Practitioner - Nurse Practitioner 3375875701 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP60991328WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Sep 1, 2019 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Sep 1, 2019 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

16515 Meridian E
Ste 104A
South Hill, WA 98375
Phone (253) 697-3030

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: lisa.nguyen.1@30646.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1881241461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16515 MERIDIAN E STE 104A",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983756255",
            "telephone_number": "253-792-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 3RD ST SE STE 300",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723771",
            "telephone_number": "253-697-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LISA",
        "middle_name": "THU",
        "name_prefix": "Miss",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-20",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60991328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.