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General NPI Number Information
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NPI Number | 1326377235
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Entity Type | Individual
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Provider Name | VANTRANG THI NGUYEN D.O.
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Gender | Female
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Dates
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Enumeration Date | 12/24/2009
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 1321 NE 99TH AVE SUITE 100
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City | PORTLAND
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State | OR
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Zip | 97220-9436
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Country | US
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Telephone | 503-215-9900
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Fax | 503-215-4055
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Provider Business Mailing Address
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Address Line | 619 NW 6TH AVE FL 5
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City | PORTLAND
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State | OR
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Zip | 97209-3964
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Country | US
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Telephone | 503-988-7468
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO28663
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License Number State | OR
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