Individual
DR. QUANG NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
25691 SE STARK ST, TROUTDALE, OR 97060-3305
(503) 667-9003
Mailing address
25691 SE STARK ST, TROUTDALE, OR 97060-3305
(503) 667-9003
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
ORRPH-0014227
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
ORRPH-0014227
OR
390200000X
Student in an Organized Health Care Education/Training Program
PI-0010980
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CV11755C
—
OR
Enumeration date
12/24/2013
Last updated
02/19/2019
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