Provider Demographics
NPI:1922197920
Name:NGUYEN, UYEN T (OD)
Entity Type:Individual
Prefix:DR
First Name:UYEN
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8129 SW 168TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-6504
Mailing Address - Country:US
Mailing Address - Phone:503-642-5550
Mailing Address - Fax:
Practice Address - Street 1:9710 SE WASHINGTON ST
Practice Address - Street 2:SUITE D
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-8407
Practice Address - Country:US
Practice Address - Phone:503-257-7770
Practice Address - Fax:503-257-1322
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2959T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist