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Individual

KHOA QUACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O

Contact information

Practice address
10123 SE MARKET ST, PORTLAND, OR 97216-2532
(503) 257-2500
Mailing address
11575 SW PACIFIC HWY # 2050, TIGARD, OR 97223-8671
(503) 560-2032

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
DO0188231
OR
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500745302
OR
Enumeration date
06/19/2014
Last updated
02/06/2024
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