Individual
DR. LONG EARON THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
24800 SE STARK ST, GRESHAM, OR 97030-3378
(503) 413-8407
Mailing address
2650 NE 6TH PL, PORTLAND, OR 97212-3880
(503) 867-7530
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
DO27806
OR
Other
Enumeration date
06/28/2007
Last updated
12/22/2021
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