Healthcare Provider Details
I. General information
NPI: 1174468565
Provider Name (Legal Business Name): EDWARD L TRAN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1908 NW 1ST WAY STE 113
BATTLE GROUND WA
98604-4560
US
IV. Provider business mailing address
11005 NE 55TH AVE
VANCOUVER WA
98686-3931
US
V. Phone/Fax
- Phone: 503-810-0599
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EDWARD
LAI
TRAN
Title or Position: DR.
Credential: DDS
Phone: 503-810-0599