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NPI Code Detail

MEDICARE: THANH TA HOANG

MEDICARE: THANH TA HOANG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPH-0016916OR

General Provider Information

NPI Number : 1033684139
Entity Type Code : Individual
Provider Name (Legal Business Name) : THANH TA HOANG
Provider Business Mailing Address
First Line : 3930 SE POWELL BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97202-1722
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3930 SE POWELL BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97202-1722
Country : US
Telephone Number : 503-772-4445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2018
Last Update Date : 10/04/2018

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Directions to “ THANH TA HOANG ” Practice Location

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