Provider Demographics
NPI:1326484189
Name:NGUYEN, THIEN T (RPH)
Entity Type:Individual
Prefix:
First Name:THIEN
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:THIEN
Other - Middle Name:T
Other - Last Name:LUTTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:9045 SW WASHINGTON DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-6840
Mailing Address - Country:US
Mailing Address - Phone:503-944-9441
Mailing Address - Fax:503-255-4220
Practice Address - Street 1:9045 SW WASHINGTON DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-6840
Practice Address - Country:US
Practice Address - Phone:503-944-9441
Practice Address - Fax:503-255-4220
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0010037183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist