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NPI Code Detail

MEDICARE: WARREN VANG

MEDICARE: WARREN VANG
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
1390200000XStudent in an Organized Health Care Education/Training ProgramOR

General Provider Information

NPI Number : 1548154578
Entity Type Code : Individual
Provider Name (Legal Business Name) : WARREN VANG
Provider Business Mailing Address
First Line : 9036 N GILBERT PL
Second Line :
City : PORTLAND
State : OR
Zip : 97203-6222
Country : US
Telephone Number : 503-560-9173
Fax Number :
Provider Business Practice Location Address
First Line : 6850 N LOMBARD ST
Second Line :
City : PORTLAND
State : OR
Zip : 97203-6247
Country : US
Telephone Number : 503-240-2733
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2025
Last Update Date : 06/04/2025

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Directions to “ WARREN VANG ” Practice Location

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