Provider Demographics
NPI:1649724741
Name:NGUYEN, THUY-AN VU (CNM)
Entity type:Individual
Prefix:
First Name:THUY-AN
Middle Name:VU
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13160 JERUSALEM HILL RD NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304
Mailing Address - Country:US
Mailing Address - Phone:503-315-2229
Mailing Address - Fax:
Practice Address - Street 1:13160 JERUSALEM HILL RD NW
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-9622
Practice Address - Country:US
Practice Address - Phone:503-315-2229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201509378NP-PP367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife