Individual
CUONG THAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4400 NE HALSEY ST, PORTLAND, OR 97213-1545
(719) 352-2636
Mailing address
4400 NE HALSEY ST, PORTLAND, OR 97213-1545
(971) 352-2636
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/26/2016
Last updated
12/05/2024
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