Provider Demographics
NPI:1447771076
Name:DOAN, KHOA DOAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KHOA
Middle Name:DOAN
Last Name:DOAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14082 SE 118TH DR
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5722
Mailing Address - Country:US
Mailing Address - Phone:503-875-4921
Mailing Address - Fax:
Practice Address - Street 1:16300 SE EVELYN ST
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9515
Practice Address - Country:US
Practice Address - Phone:503-305-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0015930183500000X
WA60674187183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist