Healthcare Provider Details

I. General information

NPI: 1275609349
Provider Name (Legal Business Name): TZANN T FANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15700 SW GREYSTONE CT
BEAVERTON OR
97006-6011
US

IV. Provider business mailing address

15700 SW GREYSTONE CT
BEAVERTON OR
97006-6011
US

V. Phone/Fax

Practice location:
  • Phone: 971-262-9000
  • Fax: 971-262-9010
Mailing address:
  • Phone: 971-262-9000
  • Fax: 971-262-9010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number036098895
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD202120
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberEL10705
License Number StateNH
# 4
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberEL10705
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: