Healthcare Provider Details

I. General information

NPI: 1295945822
Provider Name (Legal Business Name): THUYNGOC T HOANG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 01/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11619 ISLAND AVE
ISLAND CITY OR
97850-8459
US

IV. Provider business mailing address

16610 NW AVONDALE DR
BEAVERTON OR
97006-7753
US

V. Phone/Fax

Practice location:
  • Phone: 541-963-5460
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0010725
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: