MEDICARE: NHU-HA TRAN DMD

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	122300000X	Dentist	D9497	OR

General Provider Information

NPI Number	:	1639486459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NHU-HA TRAN DMD

Provider Business Mailing Address
First Line	:	2850 SE 82ND AVE UNIT 8
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97266-1599
Country	:	US
Telephone Number	:	503-788-1415
Fax Number	:

Provider Business Practice Location Address
First Line	:	2850 SE 82ND AVE UNIT 8
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97266-1599
Country	:	US
Telephone Number	:	503-788-1415
Fax Number	:

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

Provider Enumeration Date	:	09/01/2010
Last Update Date	:	04/18/2012

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Directions to “ NHU-HA TRAN DMD” Practice Location

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