Individual
THIEN CHUONG RICHARD LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1112 NW CIRCLE BLVD, CORVALLIS, OR 97330-1462
(541) 768-1221
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD189729
OR
Other
Enumeration date
07/22/2014
Last updated
08/16/2024
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