Provider Demographics
NPI:1649994310
Name:TRAN, VY TUONG (RPH)
Entity type:Individual
Prefix:
First Name:VY
Middle Name:TUONG
Last Name:TRAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 SE 153RD AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-2837
Mailing Address - Country:US
Mailing Address - Phone:503-501-9653
Mailing Address - Fax:
Practice Address - Street 1:5253 SE 82ND AVE STE 27
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-4885
Practice Address - Country:US
Practice Address - Phone:503-477-8453
Practice Address - Fax:503-477-8416
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0019194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist