Provider Demographics
NPI:1750761573
Name:HUYNH, LETICIA (MD)
Entity type:Individual
Prefix:DR
First Name:LETICIA
Middle Name:
Last Name:HUYNH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12040 NE 128TH ST
Mailing Address - Street 2:MS-50
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3013
Mailing Address - Country:US
Mailing Address - Phone:425-899-1920
Mailing Address - Fax:425-899-1933
Practice Address - Street 1:8980 161ST AVE NE STE 400
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7554
Practice Address - Country:US
Practice Address - Phone:425-899-2273
Practice Address - Fax:425-899-2272
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-06
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61107809207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty