Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Johnny Thanh Nguyen

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1104308394

Johnny Thanh Nguyen is a Physician Assistant in Bellevue, Washington. Qualified in 2019, 7 years ago. Practices with Overlake Medical Clinics LLC, a 426-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
7
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

1135 116th Ave NE Ste 605
Bellevue, WA 98004-4697
Phone: (425) 454-8161
Fax: (425) 454-9304
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4311 11th Ave Ne Ste 200, Seattle, WA 98105-6367 — (206) 616-4001

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1104308394
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 4, 2018
Last updated in NPPESAugust 29, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Overlake Medical Clinics Llc — 426 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Bellevue