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General NPI Number Information
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NPI Number | 1033687041
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Entity Type | Individual
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Provider Name | QUE PHUNG THI NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 11/07/2018
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Last Update Date | 11/07/2018
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Provider Practice Location Address
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Address Line | 2900 HAWORTH AVE
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City | NEWBERG
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State | OR
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Zip | 97132-2000
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Country | US
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Telephone | 503-538-0691
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Fax |
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Provider Business Mailing Address
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Address Line | 13353 SW ANGUS CT
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City | TIGARD
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State | OR
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Zip | 97224-1860
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Country | US
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Telephone | 503-954-6777
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PI-0012624
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License Number State | OR
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