Provider Demographics
NPI:1578859849
Name:LE, THUY XUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:THUY
Middle Name:XUAN
Last Name:LE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 NW 22ND AVE STE 480
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210
Mailing Address - Country:US
Mailing Address - Phone:503-413-6555
Mailing Address - Fax:
Practice Address - Street 1:1040 NW 22ND AVE STE 480
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3062
Practice Address - Country:US
Practice Address - Phone:503-413-6555
Practice Address - Fax:503-413-6563
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-24
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA123680207RN0300X
ORMD182237207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology