Individual
DR. FAWN TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10200 SW EASTRIDGE ST, SUITE 205, PORTLAND, OR 97225-5064
(503) 280-4555
(503) 280-4559
Mailing address
10200 SW EASTRIDGE ST, SUITE 205, PORTLAND, OR 97225-5064
(503) 280-4555
(503) 280-4559
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD22331
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500614183
—
OR
01
—
P01165691
RR MEDICARE- PROVIDENCE
OR
Enumeration date
08/17/2006
Last updated
06/25/2021
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