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General NPI Number Information
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NPI Number | 1023327103
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Entity Type | Individual
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Provider Name | HAYDEN MINH NGUYEN O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/06/2010
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Last Update Date | 06/22/2021
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Provider Practice Location Address
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Address Line | 8315 SE STARK ST
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City | PORTLAND
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State | OR
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Zip | 97216-1143
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Country | US
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Telephone | 503-282-3070
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Fax | 503-287-3482
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Provider Business Mailing Address
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Address Line | 6108 SE LAFAYETTE ST
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City | PORTLAND
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State | OR
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Zip | 97206-2854
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Country | US
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Telephone | 503-740-2446
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3524ATI
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License Number State | OR
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