Provider Demographics
NPI:1437531522
Name:TRAN, HAN MAI
Entity Type:Individual
Prefix:
First Name:HAN
Middle Name:MAI
Last Name:TRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 NW 9TH AVE APT 329
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-2868
Mailing Address - Country:US
Mailing Address - Phone:949-344-6010
Mailing Address - Fax:
Practice Address - Street 1:12000 SE 82ND AVE
Practice Address - Street 2:SUITE 2012
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-7721
Practice Address - Country:US
Practice Address - Phone:503-652-1788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-24
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3619AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist