Provider Demographics
NPI:1811033681
Name:TAFT, THAO THI (QMHA)
Entity Type:Individual
Prefix:MS
First Name:THAO
Middle Name:THI
Last Name:TAFT
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:MS
Other - First Name:THAO
Other - Middle Name:PHUONG
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13115 SE FOSTER RD UNIT 36
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-4586
Mailing Address - Country:US
Mailing Address - Phone:503-761-5664
Mailing Address - Fax:
Practice Address - Street 1:7511 SE HENRY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-6445
Practice Address - Country:US
Practice Address - Phone:503-771-6061
Practice Address - Fax:503-771-7514
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator