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Individual

VIEN THAO LUU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
417 SW 117TH AVE, 2ND FLOOR, PORTLAND, OR 97225-5924
(503) 216-9400
(503) 216-9499
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD20781
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
150759
OR
01
P00298494
RR MEDICARE
OR
Enumeration date
06/25/2006
Last updated
10/06/2020
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