Provider Demographics
NPI:1235642091
Name:DO, NHU THAO T
Entity Type:Individual
Prefix:
First Name:NHU THAO
Middle Name:T
Last Name:DO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:OLIVIA
Other - Middle Name:
Other - Last Name:DO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:8150 SE 23RD AVE APT 406
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-6877
Mailing Address - Country:US
Mailing Address - Phone:949-677-8300
Mailing Address - Fax:
Practice Address - Street 1:18055 SW TUALATIN VALLEY HWY
Practice Address - Street 2:
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97003-3953
Practice Address - Country:US
Practice Address - Phone:503-642-3018
Practice Address - Fax:503-642-3018
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR23767225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist