Provider Demographics
NPI:1568748051
Name:TO, NGOC QUE (RPH)
Entity Type:Individual
Prefix:
First Name:NGOC
Middle Name:QUE
Last Name:TO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:NGOC
Other - Middle Name:QUE
Other - Last Name:TO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:17779 LOWER BOONES FERRY RD
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-5237
Mailing Address - Country:US
Mailing Address - Phone:503-675-2509
Mailing Address - Fax:503-675-2512
Practice Address - Street 1:14555 SW TEAL BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-6193
Practice Address - Country:US
Practice Address - Phone:503-590-9756
Practice Address - Fax:503-590-6301
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10169183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist