Individual
LOAN THUY DUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
860 BELTLINE RD, SPRINGFIELD, OR 97477-1091
(541) 222-6005
(541) 222-6029
Mailing address
1115 SE 164TH AVE DEPT 358, VANCOUVER, WA 98683-8004
(360) 729-1253
(360) 729-3185
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO159382
OR
207Q00000X
Family Medicine Physician
P1636
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP10033765
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP10033765
TEXAS MEDICAL BOARD PHYSICIAN IN-TRAINING
TX
Enumeration date
06/14/2009
Last updated
07/08/2020
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