Individual
PHI JOHNNY TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
1727 NE 13TH AVE, PORTLAND, OR 97212-4378
(503) 249-1100
Mailing address
728 SE 142ND AVE, PORTLAND, OR 97233-2226
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6903
OR
Other
Enumeration date
04/11/2016
Last updated
04/11/2016
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