Provider Demographics
NPI:1942210638
Name:NGUYEN, DUNG TUAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:DUNG
Middle Name:TUAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:YOUNG
Other - Middle Name:TUAN
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:3409 NE 62ND AVE
Mailing Address - Street 2:APT 207
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-0207
Mailing Address - Country:US
Mailing Address - Phone:360-695-9459
Mailing Address - Fax:
Practice Address - Street 1:1601 E FOURTH PLAIN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3753
Practice Address - Country:US
Practice Address - Phone:360-690-1837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11612183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist