Provider Demographics
NPI:1235640277
Name:TRUONG, DAN MINH (DC)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:MINH
Last Name:TRUONG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 SW GREENBURG RD STE 185
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-5405
Mailing Address - Country:US
Mailing Address - Phone:503-206-4620
Mailing Address - Fax:503-213-9800
Practice Address - Street 1:9900 SW GREENBURG RD STE 185
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-5405
Practice Address - Country:US
Practice Address - Phone:503-206-4620
Practice Address - Fax:503-213-9800
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor