Provider Demographics
NPI:1821263534
Name:NGUYEN, MINH DUC (OTD)
Entity Type:Individual
Prefix:
First Name:MINH
Middle Name:DUC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4157 GERANIUM AVE NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-3924
Mailing Address - Country:US
Mailing Address - Phone:503-851-2453
Mailing Address - Fax:503-991-5355
Practice Address - Street 1:1130 LIBERTY ST SE STE 2
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4143
Practice Address - Country:US
Practice Address - Phone:503-339-7781
Practice Address - Fax:503-991-5355
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist