Provider Demographics
NPI:1023327103
Name:NGUYEN, HAYDEN MINH (OD)
Entity type:Individual
Prefix:DR
First Name:HAYDEN
Middle Name:MINH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:HIEU
Other - Middle Name:MINH
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6108 SE LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-2854
Mailing Address - Country:US
Mailing Address - Phone:503-740-2446
Mailing Address - Fax:
Practice Address - Street 1:8315 SE STARK ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-1143
Practice Address - Country:US
Practice Address - Phone:503-282-3070
Practice Address - Fax:503-287-3482
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-06
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3524ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist