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General NPI Number Information
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NPI Number | 1558625897
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Entity Type | Individual
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Provider Name | DUONG THUY THAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/02/2012
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | 1000 S SCHEUBER RD
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City | CENTRALIA
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State | WA
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Zip | 98531-8877
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Country | US
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Telephone | 360-330-8950
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3360
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City | PORTLAND
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State | OR
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Zip | 97208-3360
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Country | US
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Telephone | 866-366-2983
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD156990
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207VC0200X
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Taxonomy Name | Critical Care Medicine (Obstetrics & Gynecology) Physician
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License Number | MD60276967
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | MD60276967
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | MD60276967
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD60276967
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License Number State | WA
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