MEDICARE: DR. NGU THIEN NGUYEN MD

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	207Q00000X	Family Medicine Physician	1667-320	WI
2	207Q00000X	Family Medicine Physician	MD227493	OR

General Provider Information

NPI Number	:	1487913125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NGU THIEN NGUYEN MD

Provider Business Mailing Address
First Line	:	500 NE MULTNOMAH ST STE 100
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97232-2031
Country	:	US
Telephone Number	:	800-813-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2850 NW NICOLAI ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97210-2018
Country	:	US
Telephone Number	:	800-813-2000
Fax Number	:

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

Provider Enumeration Date	:	05/15/2012
Last Update Date	:	01/06/2026

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