Healthcare Provider Details

I. General information

NPI: 1467117358
Provider Name (Legal Business Name): VICTORIA HOANG RN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2021
Last Update Date: 11/04/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 NE MULTNOMAH ST STE 100
PORTLAND OR
97232-2031
US

IV. Provider business mailing address

6811 NE BROADWAY
PORTLAND OR
97213-5304
US

V. Phone/Fax

Practice location:
  • Phone: 503-813-2619
  • Fax:
Mailing address:
  • Phone: 503-258-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number201602281RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: