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General NPI Number Information
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NPI Number | 1811861537
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Entity Type | Individual
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Provider Name | PHUONG TAN MY NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 10/04/2025
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Last Update Date | 10/04/2025
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Provider Practice Location Address
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Address Line | 11398 SE 82ND AVE
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City | HAPPY VALLEY
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State | OR
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Zip | 97086-7637
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Country | US
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Telephone | 503-231-8228
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Fax |
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Provider Business Mailing Address
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Address Line | 9682 SE PARKWOOD WAY
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City | HAPPY VALLEY
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State | OR
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Zip | 97086-6024
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Country | US
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Telephone | 503-858-9977
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | H8534
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License Number State | OR
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