Provider Demographics
NPI:1003289588
Name:NGUYEN, HONG NGOC (PHARMD)
Entity Type:Individual
Prefix:
First Name:HONG NGOC
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 NORTH 5TH STREET
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355
Mailing Address - Country:US
Mailing Address - Phone:541-451-7119
Mailing Address - Fax:
Practice Address - Street 1:675 N FIFTH STREET
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355
Practice Address - Country:US
Practice Address - Phone:541-451-7119
Practice Address - Fax:541-451-7072
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0012308183500000X
ORORRPH-00123081835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist