Provider Demographics
NPI:1902107998
Name:NGUYEN, HONG A (RPH)
Entity Type:Individual
Prefix:
First Name:HONG
Middle Name:A
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14555 SW TEAL BLVD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-6193
Mailing Address - Country:US
Mailing Address - Phone:503-590-9756
Mailing Address - Fax:503-590-6301
Practice Address - Street 1:14555 SW TEAL BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-6193
Practice Address - Country:US
Practice Address - Phone:503-590-9756
Practice Address - Fax:503-590-6301
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10098183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist