MEDICARE: GORETTI NGUYEN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	5835	OR

General Provider Information

NPI Number	:	1326562281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GORETTI NGUYEN DC

Provider Business Mailing Address
First Line	:	19355 SW MOHAVE CT STE 100
Second Line	:
City	:	TUALATIN
State	:	OR
Zip	:	97062-8631
Country	:	US
Telephone Number	:	503-486-5199
Fax Number	:	503-486-5190

Provider Business Practice Location Address
First Line	:	19355 SW MOHAVE CT STE 100
Second Line	:
City	:	TUALATIN
State	:	OR
Zip	:	97062-8631
Country	:	US
Telephone Number	:	503-486-5199
Fax Number	:	503-486-5199

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2017
Last Update Date	:	01/25/2024

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Directions to “ GORETTI NGUYEN DC” Practice Location

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