Provider Demographics
NPI:1871861047
Name:NGUYEN, HANH T (PHD)
Entity Type:Individual
Prefix:DR
First Name:HANH
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15627 SE KESTREL DR
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-3610
Mailing Address - Country:US
Mailing Address - Phone:503-810-9553
Mailing Address - Fax:
Practice Address - Street 1:451 NE 181ST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-6660
Practice Address - Country:US
Practice Address - Phone:503-667-9878
Practice Address - Fax:503-669-7001
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0011102183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist