Provider Demographics
NPI:1083345292
Name:LUU, OLIVIA PHAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:PHAN
Last Name:LUU
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 1:788 SE 55TH PL
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-3682
Mailing Address - Country:US
Mailing Address - Phone:503-807-0125
Mailing Address - Fax:
Practice Address - Street 1:8145 SW BARBUR BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-2849
Practice Address - Country:US
Practice Address - Phone:503-452-6212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-19
Last Update Date:2022-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPI-0013535183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist