Provider Demographics
NPI:1043083041
Name:LIANG, DUYEN VAN (MSN, RN)
Entity Type:Individual
Prefix:
First Name:DUYEN
Middle Name:VAN
Last Name:LIANG
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17905 MONTICELLO DR
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:OR
Mailing Address - Zip Code:97027-1338
Mailing Address - Country:US
Mailing Address - Phone:660-815-3697
Mailing Address - Fax:
Practice Address - Street 1:17905 MONTICELLO DR
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:OR
Practice Address - Zip Code:97027-1338
Practice Address - Country:US
Practice Address - Phone:660-815-3697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201341363RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse